The clinical features of the overlap between COPD and asthma

COPDGene Investigators

Research output: Contribution to journalArticle

278 Citations (Scopus)

Abstract

Background: The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods: We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results: 119 (13%) of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001) with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001). More African-Americans reported a history of asthma (33.6% vs 15.6%, p <0.0001). Subjects with COPD and asthma demonstrated worse disease-related quality of life, were more likely to have had a severe COPD exacerbation in the past year, and were more likely to experience frequent exacerbations (OR 3.55 [2.19, 5.75], p <0.0001). Subjects with COPD and asthma demonstrated greater gas-trapping on chest CT. There were no differences in spirometry or CT measurements of emphysema or airway wall thickness. Conclusion: Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration: ClinicalTrials.gov: NCT00608764.

Original languageEnglish (US)
Article number127
JournalRespiratory Research
Volume12
Issue number1
DOIs
StatePublished - Sep 27 2011

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Chronic Obstructive Pulmonary Disease
Asthma
Smoking
Spirometry
Thorax
Quality of Life
Emphysema
African Americans
Cross-Sectional Studies
Gases
History
Physicians
Population

Keywords

  • Airway hyperresponsiveness
  • Asthma
  • Chronic obstructive pulmonary disease
  • Emphysema
  • Exacerbation
  • Gas-trapping

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

The clinical features of the overlap between COPD and asthma. / COPDGene Investigators.

In: Respiratory Research, Vol. 12, No. 1, 127, 27.09.2011.

Research output: Contribution to journalArticle

COPDGene Investigators. / The clinical features of the overlap between COPD and asthma. In: Respiratory Research. 2011 ; Vol. 12, No. 1.
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abstract = "Background: The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods: We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results: 119 (13{\%}) of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001) with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001). More African-Americans reported a history of asthma (33.6{\%} vs 15.6{\%}, p <0.0001). Subjects with COPD and asthma demonstrated worse disease-related quality of life, were more likely to have had a severe COPD exacerbation in the past year, and were more likely to experience frequent exacerbations (OR 3.55 [2.19, 5.75], p <0.0001). Subjects with COPD and asthma demonstrated greater gas-trapping on chest CT. There were no differences in spirometry or CT measurements of emphysema or airway wall thickness. Conclusion: Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration: ClinicalTrials.gov: NCT00608764.",
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AU - Silverman, Edwin K.

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AU - Schroeder, Joyce D.

AU - Make, Barry J.

AU - Crapo, James D.

AU - Hersh, Craig P.

AU - Curtis, Jeffrey

AU - Kazerooni, Ella

AU - Hanania, Nicola

AU - Alapat, Philip

AU - Bandi, Venkata

AU - Guntupalli, Kalpalatha

AU - Guy, Elizabeth

AU - Mallampalli, Antara

AU - Trinh, Charles

AU - Atik, Mustafa

AU - DeMeo, Dawn

AU - Hersh, Craig

AU - Washko, George

AU - Jacobson, Francine

AU - Graham Barr, R.

AU - Thomashow, Byron

AU - Austin, John

AU - Neil MacIntyre, MacIntyre

AU - Washington, Lacey

AU - Page McAdams, H.

AU - Rosiello, Richard

AU - Bresnahan, Timothy

AU - McEvoy, Charlene

AU - Tashjian, Joseph

AU - Wise, Robert

AU - Hansel, Nadia

AU - Brown, Robert

AU - Diette, Gregory

AU - Casaburi, Richard

AU - Porszasz, Janos

AU - Fischer, Hans

AU - Budoff, Matt

AU - Sharafkhaneh, Amir

AU - Trinh, Charles

AU - Kamal, Hirani

AU - Darvishi, Roham

AU - Niewoehner, Dennis

AU - Allen, Tadashi

AU - Anderson, Quentin

AU - Rice, Kathryn

AU - Anzueto, Antonio R

AU - Adams, Sandra G

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N2 - Background: The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods: We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results: 119 (13%) of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001) with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001). More African-Americans reported a history of asthma (33.6% vs 15.6%, p <0.0001). Subjects with COPD and asthma demonstrated worse disease-related quality of life, were more likely to have had a severe COPD exacerbation in the past year, and were more likely to experience frequent exacerbations (OR 3.55 [2.19, 5.75], p <0.0001). Subjects with COPD and asthma demonstrated greater gas-trapping on chest CT. There were no differences in spirometry or CT measurements of emphysema or airway wall thickness. Conclusion: Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration: ClinicalTrials.gov: NCT00608764.

AB - Background: The coexistence of COPD and asthma is widely recognized but has not been well described. This study characterizes clinical features, spirometry, and chest CT scans of smoking subjects with both COPD and asthma. Methods: We performed a cross-sectional study comparing subjects with COPD and asthma to subjects with COPD alone in the COPDGene Study. Results: 119 (13%) of 915 subjects with COPD reported a history of physician-diagnosed asthma. These subjects were younger (61.3 vs 64.7 years old, p = 0.0001) with lower lifetime smoking intensity (43.7 vs 55.1 pack years, p = 0.0001). More African-Americans reported a history of asthma (33.6% vs 15.6%, p <0.0001). Subjects with COPD and asthma demonstrated worse disease-related quality of life, were more likely to have had a severe COPD exacerbation in the past year, and were more likely to experience frequent exacerbations (OR 3.55 [2.19, 5.75], p <0.0001). Subjects with COPD and asthma demonstrated greater gas-trapping on chest CT. There were no differences in spirometry or CT measurements of emphysema or airway wall thickness. Conclusion: Subjects with COPD and asthma represent a relevant clinical population, with worse health-related quality of life. They experience more frequent and severe respiratory exacerbations despite younger age and reduced lifetime smoking history. Trial registration: ClinicalTrials.gov: NCT00608764.

KW - Airway hyperresponsiveness

KW - Asthma

KW - Chronic obstructive pulmonary disease

KW - Emphysema

KW - Exacerbation

KW - Gas-trapping

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