Chest
Original Research: AsthmaIncreased Risk of Exacerbation and Hospitalization in Subjects With an Overlap Phenotype: COPD-Asthma
Section snippets
Materials and Methods
The PLATINO study was a population-based survey carried out in Latin America; subjects performed spirometry with a portable spirometer (EasyOne spirometer; ndd Medical Technologies, Inc) at baseline and 15 min after the administration of 200 μg of salbutamol, according to the American Thoracic Society criteria of acceptability and reproducibility.10 Complete details of the methodology have been published elsewhere.11
The outcomes of this paper were self-reported exacerbations in the last year
Results
Out of the population of 5,044 subjects, 767 were classified as having one phenotype; 594 (11.7%) belonged to the COPD group, 84 (1.7%) to the asthmatic group, and 89 (1.8%) to the overlap group (Fig 1). The prevalence of these phenotypes using “medical diagnosis of asthma” is shown as e-Figure 1. e-Figure 2 shows the prevalence of these phenotypes calculated with a denominator of 767 (only those affected with asthma and COPD) rather than 5,044, as shown in Figure 1. The prevalence for overlap
Discussion
The principal findings of this study were as follows. First, using the GOLD criteria to define COPD, the presence of both wheezing and acute BD responsiveness to define asthma, and the combination of the two previous criteria for classifying the overlap COPD-asthma, we found that 1.7% of the PLATINO population belonged to the asthmatic group, around 12% to the COPD group, and 1.8% were classified in the overlap group. Second, subjects with COPD-asthma overlap had more respiratory symptoms;
Acknowledgments
Author contributions: Dr Menezes is guarantor of the manuscript and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Menezes: contributed by coordinating the PLATINO study, designed the analysis, wrote the manuscript, and revised and approved the article.
Dr Montes de Oca: contributed as the principal investigator in Caracas, designed the analysis, wrote the manuscript, and revised and approved the article.
Dr Pérez-Padilla: contributed as the principal
References (30)
- et al.
International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study
Lancet
(2007) - et al.
Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study)
Chest
(2008) - et al.
Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study
Lancet
(2005) - et al.
Diagnostic labeling of COPD in five Latin American cities
Chest
(2007) - et al.
Spirometric reference values in 5 large Latin American cities for subjects aged 40 years or over [in Spanish]
Arch Bronconeumol
(2006) - et al.
Clinical application of a simple questionnaire for the differentiation of asthma and chronic obstructive pulmonary disease
Respir Med
(2004) - et al.
The proportional Venn diagram of obstructive lung disease: two approximations from the United States and the United Kingdom
Chest
(2003) - et al.
Prevalence and characteristics of three clinical phenotypes of chronic obstructive pulmonary disease (COPD)
Respir Med
(2013) - et al.
Characterisation of the overlap COPD-asthma phenotype. Focus on physical activity and health status
Respir Med
(2013) - et al.
The costs of exacerbations in chronic obstructive pulmonary disease (COPD)
Respir Med
(2002)
Pharmacoeconomic evaluation of COPD
Chest
Pharmacoeconomic evaluation of acute exacerbations of chronic bronchitis and COPD
Chest
Current and future medical costs of asthma and chronic obstructive pulmonary disease in The Netherlands
Respir Med
Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey
Am J Respir Crit Care Med
Global strategy for asthma management and prevention: GINA executive summary
Eur Respir J
Cited by (324)
Clinical phenotypes of COPD and their impact on quality of life: A cross-sectional study
2023, Respiratory MedicineGEMA 5.3. Spanish Guideline on the Management of Asthma
2023, Open Respiratory ArchivesCurrent Limitations and Recent Advances in the Management of Asthma
2023, Disease-a-MonthCitation Excerpt :However, a patient can have asthma and COPD, or asthma and interstitial lung disease. These combinations result in worse symptoms and a higher risk for exacerbations and hospitalizations than either disorder alone.62,63 An important factor that can help differentiate asthma from COPD is smoking history.
Metabolomics in COPD
2023, Archivos de BronconeumologiaComorbidities Modify the Phenotype but Not the Treatment Effectiveness to Mepolizumab in Severe Eosinophilic Asthma
2023, Journal of Allergy and Clinical Immunology: In PracticeAirway and parenchymal transcriptomics in a novel model of asthma and COPD overlap
2022, Journal of Allergy and Clinical Immunology
*A complete list of PLATINO team participants is located in e-Appendix 1.
Funding/Support: The PLATINO study was funded by Boehringer Ingelheim GmbH; GlaxoSmithKline supported the analysis presented in this paper.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.