{"title":"重症哮喘中哮喘与慢性阻塞性肺疾病重叠的发生率和临床影响。","authors":"Miho Wakazono, Hirokazu Kimura, Ichizo Tsujino, Nobuyasu Wakazono, Michiko Takimoto-Sato, Munehiro Matsumoto, Kaoruko Shimizu, Houman Goudarzi, Hironi Makita, Masaharu Nishimura, Satoshi Konno","doi":"10.1016/j.alit.2024.11.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with asthma-COPD overlap (ACO) have a greater symptom burden, worse respiratory function, and more frequent exacerbations than those with asthma alone. However, only a few studies have investigated the prevalence and clinical course of ACO in severe asthma. This study aimed to examine the comorbid rate of ACO and its clinical impact on severe asthma.</p><p><strong>Methods: </strong>We prospectively enrolled 127 patients with severe asthma from 30 hospitals and clinics. Favorable treatment adherence was ensured, and the prevalence of ACO was assessed using the Japanese Respiratory Society ACO criteria. Patients were categorized into two groups, ACO and non-ACO, and their clinical characteristics were compared. The exacerbation rates with a 3-year follow-up and the annual change in FEV<sub>1</sub> with a 5-year follow-up of 105 individuals were evaluated. The exacerbation-free rate was analyzed using the Kaplan-Meier method and the Cox proportional hazards model.</p><p><strong>Results: </strong>The prevalence of ACO in severe asthma was 31.5 %. Patients with ACO were older, more frequently male, and had a longer duration of asthma than those without. No significant difference was observed in exacerbation rates between the ACO and non-ACO groups (62.2 % vs. 63.2 %, P = 0.91) or the annual change in FEV<sub>1</sub> (-39.2 mL/year vs. -31.2 mL/year, P = 0.11).</p><p><strong>Conclusions: </strong>The prevalence of ACO in our multicenter cohort study on severe asthma was approximately 30 %. The presence of ACO was not an independent risk for exacerbations or decline in FEV<sub>1</sub>.</p>","PeriodicalId":48861,"journal":{"name":"Allergology International","volume":" ","pages":""},"PeriodicalIF":6.2000,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence and clinical impact of asthma-COPD overlap in severe asthma.\",\"authors\":\"Miho Wakazono, Hirokazu Kimura, Ichizo Tsujino, Nobuyasu Wakazono, Michiko Takimoto-Sato, Munehiro Matsumoto, Kaoruko Shimizu, Houman Goudarzi, Hironi Makita, Masaharu Nishimura, Satoshi Konno\",\"doi\":\"10.1016/j.alit.2024.11.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patients with asthma-COPD overlap (ACO) have a greater symptom burden, worse respiratory function, and more frequent exacerbations than those with asthma alone. However, only a few studies have investigated the prevalence and clinical course of ACO in severe asthma. This study aimed to examine the comorbid rate of ACO and its clinical impact on severe asthma.</p><p><strong>Methods: </strong>We prospectively enrolled 127 patients with severe asthma from 30 hospitals and clinics. Favorable treatment adherence was ensured, and the prevalence of ACO was assessed using the Japanese Respiratory Society ACO criteria. Patients were categorized into two groups, ACO and non-ACO, and their clinical characteristics were compared. The exacerbation rates with a 3-year follow-up and the annual change in FEV<sub>1</sub> with a 5-year follow-up of 105 individuals were evaluated. The exacerbation-free rate was analyzed using the Kaplan-Meier method and the Cox proportional hazards model.</p><p><strong>Results: </strong>The prevalence of ACO in severe asthma was 31.5 %. Patients with ACO were older, more frequently male, and had a longer duration of asthma than those without. No significant difference was observed in exacerbation rates between the ACO and non-ACO groups (62.2 % vs. 63.2 %, P = 0.91) or the annual change in FEV<sub>1</sub> (-39.2 mL/year vs. -31.2 mL/year, P = 0.11).</p><p><strong>Conclusions: </strong>The prevalence of ACO in our multicenter cohort study on severe asthma was approximately 30 %. 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引用次数: 0
摘要
背景：哮喘-慢阻肺重叠（ACO）患者比单纯哮喘患者有更大的症状负担、更差的呼吸功能和更频繁的加重。然而，只有少数研究调查了ACO在严重哮喘中的患病率和临床病程。本研究旨在探讨ACO的合并率及其对重度哮喘的临床影响。方法：前瞻性纳入来自30家医院和诊所的127例重症哮喘患者。确保良好的治疗依从性，并使用日本呼吸学会ACO标准评估ACO的患病率。将患者分为ACO和non-ACO两组，比较其临床特征。对105例患者随访3年的加重率和5年FEV1的年变化进行评估。采用Kaplan-Meier法和Cox比例风险模型分析无加重率。结果：急性哮喘患儿ACO患病率为31.5%。ACO患者年龄较大，多为男性，哮喘持续时间较长。ACO组和非ACO组的加重率无显著差异（62.2% vs. 63.2%, P = 0.91）， FEV1的年变化（-39.2 mL/年vs. -31.2 mL/年，P = 0.11）。结论：在我们的多中心队列研究中，严重哮喘的ACO患病率约为30%。ACO的存在不是FEV1恶化或下降的独立风险。
Prevalence and clinical impact of asthma-COPD overlap in severe asthma.
Background: Patients with asthma-COPD overlap (ACO) have a greater symptom burden, worse respiratory function, and more frequent exacerbations than those with asthma alone. However, only a few studies have investigated the prevalence and clinical course of ACO in severe asthma. This study aimed to examine the comorbid rate of ACO and its clinical impact on severe asthma.
Methods: We prospectively enrolled 127 patients with severe asthma from 30 hospitals and clinics. Favorable treatment adherence was ensured, and the prevalence of ACO was assessed using the Japanese Respiratory Society ACO criteria. Patients were categorized into two groups, ACO and non-ACO, and their clinical characteristics were compared. The exacerbation rates with a 3-year follow-up and the annual change in FEV1 with a 5-year follow-up of 105 individuals were evaluated. The exacerbation-free rate was analyzed using the Kaplan-Meier method and the Cox proportional hazards model.
Results: The prevalence of ACO in severe asthma was 31.5 %. Patients with ACO were older, more frequently male, and had a longer duration of asthma than those without. No significant difference was observed in exacerbation rates between the ACO and non-ACO groups (62.2 % vs. 63.2 %, P = 0.91) or the annual change in FEV1 (-39.2 mL/year vs. -31.2 mL/year, P = 0.11).
Conclusions: The prevalence of ACO in our multicenter cohort study on severe asthma was approximately 30 %. The presence of ACO was not an independent risk for exacerbations or decline in FEV1.
期刊介绍：
Allergology International is the official journal of the Japanese Society of Allergology and publishes original papers dealing with the etiology, diagnosis and treatment of allergic and related diseases. Papers may include the study of methods of controlling allergic reactions, human and animal models of hypersensitivity and other aspects of basic and applied clinical allergy in its broadest sense.
The Journal aims to encourage the international exchange of results and encourages authors from all countries to submit papers in the following three categories: Original Articles, Review Articles, and Letters to the Editor.
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