Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec;83(Supple 1):S34-S45.
doi: 10.4046/trd.2020.0031. Epub 2020 Oct 13.

Clinical Characteristics and Changes of Clinical Features in Patients with Asthma-COPD Overlap in Korea according to Different Diagnostic Criteria

Jeong Uk Lim  1 , Deog Kyeom Kim  2 , Myung Goo Lee  3 , Yong-Il Hwang  4 , Kyeong-Cheol Shin  5 , Kwang Ho In  6 , Sang Yeub Lee  7 , Chin Kook Rhee  8 , Kwang Ha Yoo  9 , Hyoung Kyu Yoon  1
Affiliations

Clinical Characteristics and Changes of Clinical Features in Patients with Asthma-COPD Overlap in Korea according to Different Diagnostic Criteria

Jeong Uk Lim et al. Tuberc Respir Dis (Seoul). 2020 Dec.

Abstract

Background: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a condition characterized by the overlapping clinical features of asthma and COPD. To evaluate the appropriateness of different sets of ACO definition, we compared the clinical characteristics of the previously defined diagnostic criteria and the specialist opinion in this study.

Methods: Patients enrolled in the KOrea COpd Subgroup Study (KOCOSS) were evaluated. Based on the questionnaire data, the patients were categorized into the ACO and non-ACO COPD groups according to the four sets of the diagnostic criteria.

Results: In total 1,475 patients evaluated: 202 of 1,475 (13.6%), 32 of 1,475 (2.2%), 178 of 1,113 (16.0%), and 305 of 1,250 (24.4%) were categorized as ACO according to the modified Spanish Society of Pneumonology and Thoracic Surgery (SEPAR), American Thoracic Society (ATS) Roundtable, Global Initiative for Asthma (GINA)/Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria, and the specialists diagnosis, respectively. The ACO group defined according to the GINA/GOLD criteria showed significantly higher St. George's Respiratory Questionnaire and COPD Assessment Test scores than the non-ACO COPD group. When the modified SEPAR definition was applied, the ACO group showed a significantly larger decrease in the forced expiratory volume in 1 second (FEV1, %). The ACO group defined by the ATS Roundtable showed significantly larger decrease in the forced vital capacity values compared to the non-ACO COPD group (-18.9% vs. -2.2%, p=0.007 and -412 mL vs. -17 mL, p=0.036). The ACO group diagnosed by the specialists showed a significantly larger decrease in the FEV1 (%) compared to the non-ACO group (-5.4% vs. -0.2%, p=0.003).

Conclusion: In this study, the prevalence and clinical characteristics of ACO varied depending on the diagnostic criteria applied. With the criteria which are relatively easy to use, defining ACO by the specialists diagnosis may be more practical in clinical applications.

Keywords: Asthma; Chronic Obstructive Lung Disease; Pulmonary Function.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Comparison of mean values of three-year changes (with standard errors) in FEV1 (%) between the ACO group and non-ACO COPD group according to ATS Roundtable (A), modified SEPAR (B), GINA/GOLD criteria (C), and specialist diagnosis (range, 2 standard error) (D). ACO: asthma-COPD overlap; ATS: American Thoracic Society; COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in 1 second; GINA: Global Initiative for Asthma; GOLD: Global Initiative for Chronic Obstructive Lung Disease; SEPAR: Spanish Society of Pneumonology and Thoracic Surgery.
Figure 2.
Figure 2.
Comparison of mean values of three-year changes (with standard errors) in FVC (%) between the ACO group and non-ACO COPD group according to ATS Roundtable (A), modified SEPAR (B), GINA/GOLD criteria (C), and specialist diagnosis (D) (range, 2 standard error). ACO: asthma-COPD overlap; ATS: American Thoracic Society; COPD: chronic obstructive pulmonary disease; FVC: forced vital capacity; GINA: Global Initiative for Asthma; GOLD: Global Initiative for Chronic Obstructive Lung Disease; SEPAR: Spanish Society of Pneumonology and Thoracic Surgery.
See this image and copyright information in PMC

References

    1. Yamamura K, Hara J, Kobayashi T, Ohkura N, Abo M, Akasaki K, et al. The prevalence and clinical features of asthma-COPD overlap (ACO) definitively diagnosed according to the Japanese Respiratory Society Guidelines for the Management of ACO 2018. J Med Invest. 2019;66:157–64. - PubMed
    1. Gibson PG, Simpson JL. The overlap syndrome of asthma and COPD: what are its features and how important is it? Thorax. 2009;64:728–35. - PubMed
    1. Sin DD, Miravitlles M, Mannino DM, Soriano JB, Price D, Celli BR, et al. What is asthma-COPD overlap syndrome? Towards a consensus definition from a round table discussion. Eur Respir J. 2016;48:664–73. - PubMed
    1. Soler-Cataluna JJ, Cosio B, Izquierdo JL, Lopez-Campos JL, Marin JM, Aguero R, et al. Consensus document on the overlap phenotype COPD-asthma in COPD. Arch Bronconeumol. 2012;48:331–7. - PubMed
    1. Sandfeld-Paulsen B, Meldgaard P, Sorensen BS, Safwat A, Aggerholm-Pedersen N. The prognostic role of inflammation-scores on overall survival in lung cancer patients. Acta Oncol. 2019;58:371–6. - PubMed