Longitudinal comparison of outcomes in patients with smoking-related asthma-COPD overlap and in non-smoking asthmatics with incomplete reversibility of airway obstruction.
Adrenal Cortex Hormones
/ administration & dosage
Anti-Bacterial Agents
/ administration & dosage
Asthma
/ diagnosis
Bronchodilator Agents
/ administration & dosage
Disease Progression
Emergency Service, Hospital
Humans
Longitudinal Studies
Lung
/ drug effects
Non-Smokers
Patient Admission
Prognosis
Pulmonary Disease, Chronic Obstructive
/ diagnosis
Smokers
Smoking
/ adverse effects
Time Factors
asthma-COPD overlap
exacerbations
fixed airflow limitation
smoking history
symptoms
Journal
International journal of chronic obstructive pulmonary disease
ISSN: 1178-2005
Titre abrégé: Int J Chron Obstruct Pulmon Dis
Pays: New Zealand
ID NLM: 101273481
Informations de publication
Date de publication:
Historique:
entrez:
19
3
2019
pubmed:
19
3
2019
medline:
30
7
2019
Statut:
epublish
Résumé
There is a need to characterize the impact of the smoking status on the clinical course of asthmatics with incomplete reversibility of airway obstruction (IRAO). To compare longitudinal health care use, symptom control, and medication needs between smoking and non-smoking asthmatics with IRAO. This was a 12-month follow-up of a cross-sectional study comparing asthmatics with IRAO according to their tobacco exposure. One group had a tobacco exposure ≥20 pack-years and was considered to have asthma-COPD overlap (ACO) and the second with a past tobacco exposure <5 pack-years was considered as non-smokers with IRAO (NS-IRAO). Study participants were contacted by telephone every 3 months to document exacerbation events and symptom control. A total of 111 patients completed all follow-up telephone calls: 71 ACO and 40 NS-IRAO. The number of exacerbations per patient over the 12-month follow-up was similar in both groups. However, ACO reported worse symptom control throughout the follow-up as compared to NS-IRAO, although no significant variations within a group were observed over the study period. Although asthma control scores were poorer in ACO patients over 1 year compared to NS-IRAO, exacerbation rate was similar and low in both groups of asthmatics. These observations suggest that poorer asthma control in ACO was not driven by the number of exacerbations but may reflect the influence of chronic airway changes related to the COPD component.
Sections du résumé
BACKGROUND
BACKGROUND
There is a need to characterize the impact of the smoking status on the clinical course of asthmatics with incomplete reversibility of airway obstruction (IRAO).
OBJECTIVE
OBJECTIVE
To compare longitudinal health care use, symptom control, and medication needs between smoking and non-smoking asthmatics with IRAO.
MATERIALS AND METHODS
METHODS
This was a 12-month follow-up of a cross-sectional study comparing asthmatics with IRAO according to their tobacco exposure. One group had a tobacco exposure ≥20 pack-years and was considered to have asthma-COPD overlap (ACO) and the second with a past tobacco exposure <5 pack-years was considered as non-smokers with IRAO (NS-IRAO). Study participants were contacted by telephone every 3 months to document exacerbation events and symptom control.
RESULTS
RESULTS
A total of 111 patients completed all follow-up telephone calls: 71 ACO and 40 NS-IRAO. The number of exacerbations per patient over the 12-month follow-up was similar in both groups. However, ACO reported worse symptom control throughout the follow-up as compared to NS-IRAO, although no significant variations within a group were observed over the study period.
CONCLUSION
CONCLUSIONS
Although asthma control scores were poorer in ACO patients over 1 year compared to NS-IRAO, exacerbation rate was similar and low in both groups of asthmatics. These observations suggest that poorer asthma control in ACO was not driven by the number of exacerbations but may reflect the influence of chronic airway changes related to the COPD component.
Identifiants
pubmed: 30880939
doi: 10.2147/COPD.S192003
pii: copd-14-493
pmc: PMC6398407
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Anti-Bacterial Agents
0
Bronchodilator Agents
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Pagination
493-498Déclaration de conflit d'intérêts
Disclosure The authors report no conflicts of interest in this work.
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