Burden of COPD, Asthma, and Concomitant COPD and Asthma Among Adults

Shaya, Fadia T.; Maneval, Mark S.; Gbarayor, Confidence M.; Sohn, Kyongsei; Dalal, Anand A.; Du, Dongyi Tony; Scharf, Steven M.

doi:10.1378/chest.08-2304

Cited by 44 publications

(33 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The average age of the COPD group was 65, which was older than the asthma group. In terms of BMI, the COPD group had a smaller BMI than both the asthma and control groups, which was an observation that is consistent with other investigators' findings [32] . Our deduction is that, on the one hand, as a chronic condition, COPD tends to affect older people.…”

Section: Discussionsupporting

confidence: 92%

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Chen

Zeng²,

Zhang³

et al. 2017

Respiration

View full text Add to dashboard Cite

Background: It is difficult to differentiate between chronic obstructive pulmonary disease (COPD) and asthma in clinics; therefore, for diagnostic purposes, imaging-based measurements could be beneficial to differentiate between the two diseases. Objectives: We aim to analyze quantitative measurements of the lung and bronchial parameters that are provided by low-dose computed tomography (CT) to differentiate COPD and asthma from an imaging perspective. Materials and Methods: 69 COPD patients, 52 asthma patients, and 20 healthy subjects were recruited to participate in CT imaging and pulmonary function tests (PFTs). Comparative analysis was performed to identify differences between COPD and asthma in CT measurements. PFT measurements enabled validation of the differentiation between COPD and asthma patients. Results: There were significant differences among the COPD, asthma, and healthy control groups. The differences were more significant among the following: inspiratory emphysema index (EI)_-950 (%), expiratory lung volume, expiratory mean lung density (MLD), and expiratory EI_-950 (%) and EI_-850 (%). The COPD group had a significantly higher EI_-950 (%) than the asthma group (p = 0.008). There were significant differences among the three groups in lumen area (LA), wall area (WA), total area, and Pi10WA. The asthma group had significantly higher WA%/WV% than both the COPD (p = 0.002) and the control group (p = 0.012). There was high sensitivity in EI_-950 (%), EI_-850 (%) and expiratory MLD in the parenchyma and high sensitivity in LA and Pi10WA in small airways in the differential diagnosis of COPD and asthma. Conclusion: To aid the diagnosis, CT can provide quantitative measurements to differentiate between COPD and asthma patients.

show abstract

Section: Discussionsupporting

confidence: 92%

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Chen

Zeng²,

Zhang³

et al. 2017

Respiration

View full text Add to dashboard Cite

show abstract

“…Paradoxical response was twice as common in African-Americans as in Caucasians. This is a novel finding that we speculate might explain some of the poor outcomes seen in African-Americans with COPDthat have often been explained by poor socioeconomic status, 27 lower heath care utilization, 28 and genetic susceptibility to greater airflow obstruction and emphysema for similar smoking burden. 29 Though respiratory medication use was lower in African-Americans in our study suggesting disparities in care, this was not a predictor of PR status.Recent advances in genetics have also identified beta receptor polymorphisms as a potential source of differential response to beta agonists in African-Americans and our findings support the assertion that this is clinically relevant.…”

Section: Discussionmentioning

confidence: 76%

Radiological correlates and clinical implications of the paradoxical lung function response to β2 agonists: an observational study

Bhatt

Wells

Kim

et al. 2014

The Lancet Respiratory Medicine

View full text Add to dashboard Cite

Background Bronchodilator response is seen in a significant proportion of patients with chronic obstructive pulmonary disease (COPD). However, there are also reports of a paradoxical response (PR) to beta2-agonists, resulting in bronchoconstriction. Asymptomatic bronchoconstriction is likely far more common but there has been no systematic study of this phenomenon.We assessed theprevalence of PR in current and former smokers with and without COPD, and its radiologic correlates and clinical implications. Methods Subjects from a large multicenter study (COPDGene) were categorized into two groups based on PR defined as at least a 12% and 200mLreduction in FEV1 and/or FVC after administration of a short-acting beta2-agonist (180ucg albuterol). Predictors of PR and associations with respiratory morbidity and computed tomographic measures of emphysema and airway disease were assessed. Findings 9986 subjects were included. PR was seen in 4.54% and the frequency was similar in those with COPD and smokers without airflow obstruction. Compared to Caucasians, PR was twice as common in African-Americans (6.9% vs. 3.4%;p <0.001). On multivariate analyses, African- American race (adjusted OR 1.89, 95%CI 1.50 to 2.39), lesspercent emphysema (OR 0.96, 95%CI 0.92 to 0.99) and increased wall-area% of segmental airways (OR 1.04,95%CI 1.01 to 1.08) were independently associated with PR.PR was independently associated with worse dyspnea, lower six-minute-walk distance, higher BODE index, and a greater frequency of exacerbations(increased by a factor of 1.35, 95%CI 1.003 to 1.81). Interpretation Paradoxical response to beta2-agonists is associated with respiratory morbidity and is more common in African Americans.

show abstract

“…CODE study participants had evidence of moderate to severe disease and evidence of airflow obstruction after administration of bronchodilator and were similarly excluded if they had a concomitant diagnosis of asthma. Even if patients with underlying asthma were inadvertently included in the analyses, there is increasing recognition that bronchodilator reversibility and asthma coexist in a substantial proportion of subjects with COPD (26,27). Even when including subjects from NHANES with doctor-diagnosed asthma, the role of the allergic phenotype on health outcomes was not substantially altered.…”

Section: Discussionmentioning

confidence: 99%

Effects of Allergic Phenotype on Respiratory Symptoms and Exacerbations in Patients with Chronic Obstructive Pulmonary Disease

Jamieson¹,

Matsui

Belli³

et al. 2013

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Chronic obstructive pulmonary disease (COPD) guidelines make no recommendations for allergy diagnosis or treatment. Objectives: To determine whether an allergic phenotype contributes to respiratory symptoms and exacerbations in patients with COPD. Methods: Two separate cohorts were analyzed: National Health and Nutrition Survey III (NHANES III) and the COPD and domestic endotoxin (CODE) cohort. Subjects from NHANES III with COPD (n ¼ 1,381) defined as age . 40 years, history of smoking, FEV 1 /FVC , 0.70, and no diagnosis of asthma were identified. The presence of an allergic phenotype (n ¼ 296) was defined as self-reported doctor diagnosed hay fever or allergic upper respiratory symptoms. In CODE, former smokers with COPD (n ¼ 77) were evaluated for allergic sensitization defined as a detectable specific IgE to perennial allergens. Bivariate and multivariate models were used to determine whether an allergic phenotype was associated with respiratory symptoms and exacerbations. Measurements and Main Results: In NHANES III, multivariate analysis revealed that individuals with allergic phenotype were more likely to wheeze (odds ratio [OR], 2.1; P , 0.01), to have chronic cough (OR, 1.9; P ¼ 0.01) and chronic phlegm (OR, 1.5; P , 0.05), and to have increased risk of COPD exacerbation requiring an acute doctor visit (OR, 1.7; P ¼ 0.04). In the CODE cohort, multivariate analysis revealed that sensitized subjects reported more wheeze (OR, 5.91; P , 0.01), more nighttime awakening due to cough (OR, 4.20; P ¼ 0.03), increased risk of COPD exacerbations requiring treatment with antibiotics (OR, 3.79; P ¼ 0.02), and acute health visits (OR, 11.05; P , 0.01). An increasing number of sensitizations was associated with a higher risk for adverse health outcomes. Conclusions: Among individuals with COPD, evidence of an allergic phenotype is associated with increased respiratory symptoms and risk of COPD exacerbations.Keywords: atopy; allergic sensitization; allergy; chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD), a chronic disease of the airways, is caused by tobacco smoke and other air pollutant exposures (1). In the United States, COPD affects 14% of the adult population and is the third leading cause of death (2). Annually, COPD is responsible for 726,000 hospitalizations and over $32 billion in estimated cost, reflecting a large public health burden (3). Patients with COPD suffer significant morbidity, including respiratory symptoms that adversely affect quality of life and limit activity (4). Given the significant morbidity, understanding the different factors that contribute to symptom burden in COPD is an important focus of research.Allergic sensitization, assessed by allergen-specific IgE or skin prick testing, is a known risk factor for asthma (5, 6), and exposure to specific allergens in sensitized patients with asthma is known to worsen pulmonary symptoms (7,8). National and international guidelines recommend assessment of allergic sensitization and environmental exposur...

show abstract

Burden of COPD, Asthma, and Concomitant COPD and Asthma Among Adults

Cited by 44 publications

References 20 publications

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Quantitative Low-Dose Computed Tomography of the Lung Parenchyma and Airways for the Differentiation between Chronic Obstructive Pulmonary Disease and Asthma Patients

Radiological correlates and clinical implications of the paradoxical lung function response to β2 agonists: an observational study

Effects of Allergic Phenotype on Respiratory Symptoms and Exacerbations in Patients with Chronic Obstructive Pulmonary Disease

Contact Info

Product

Resources

About