Health characteristics of patients with asthma, COPD and asthma–COPD overlap in the NHANES database

Abstract

Introduction

Asthma and COPD have overlapping characteristics. As there are limited data on whether asthma–COPD overlap (ACO) represents a distinct condition, this study aimed to determine the similarities and differences of ACO with asthma and COPD.

Methods

US population-based, cross-sectional study using National Health and Nutrition Examination Survey data (2009–2012) compared participants with ACO vs those with asthma or COPD, each as mutually exclusive disease states. Demographics, health status, disability/limitations, health care resource utilization, clinical characteristics, and peripheral blood eosinophil counts were analyzed.

Results

A total of 1,609, 479, and 299 participants with asthma, COPD, and ACO, respectively, were included. An age-matched asthma subgroup included 299 participants from the asthma group. Compared with asthma and COPD, participants with ACO had worse health status, increased disease burden, and more comorbid conditions. The ACO, vs age-matched asthma subgroup, had lower percent predicted prebronchodilator forced expiratory volume in 1 second (82.1% vs 88.0%; P=0.017). The ACO group had significantly more asthma attacks in the past year than the age-matched asthma subgroup (49.8% vs 38.4%; P<0.001). The ACO group had more participants with postbronchodilator forced expiratory volume in 1 second <80% predicted (52.1%) vs COPD (30.8%; P=0.003) and more participants with blood eosinophil counts ≥400 cells/µL (16.9%) vs COPD (9.5%; P=0.007) and the asthma subgroup (6.7%; P=0.014).

Conclusion

The ACO group represents an important subset of patients with chronic respiratory disease with an increased burden of disease over asthma and COPD individually. Early identification of this population will enable appropriate therapeutic interventions in a timely manner.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2018

Publication date (Electronic): 12 September 2018

Volume: 13

Pages: 2859-2868

Affiliations

[1 ]US Medical Affairs, GSK, Research Triangle Park, NC, USA, beth.a.hahn@ 123456gsk.com

[2 ]US Medical Affairs, GSK, La Jolla, CA, USA

[3 ]Groupe d’Analyse, Ltée, Montréal, QC, Canada

[4 ]Analysis Group, Inc., Boston, MA, USA

Author notes

Correspondence: Beth Hahn, US Value Evidence & Outcomes, GSK, Research Triangle Park, NC 27709, USA, Tel [phone], Email beth.a.hahn@ 123456gsk.com

Article

Publisher ID: copd-13-2859

DOI: 10.2147/COPD.S167379

PMC ID: 6143639

Copyright statement: © 2018 Llanos et al. This work is published and licensed by Dove Medical Press Limited

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Categories

Subject: Original Research