Obstructive Lung Diseases: Airways 3 |

Asthma COPD Overlap Syndrome (ACOS) in Ramathibodi Hospital Thailand FREE TO VIEW

Theerasuk Kawamatawong; Sanruethai Charoenniwassakul; Ticha Rerkpattanapipat
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Ramathibodi Hospital, Bangkok, Thailand

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):849A. doi:10.1016/j.chest.2016.08.949
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To investigate prevalence of ACOS in clinician diagnosed obstructive airway disease patients. In addition, we compared clinical and laboratory findings of ACOS to pure asthma and pure COPD.

METHODS: Cross sectional study was conducted by recruiting obstructive airway disease patients in outpatient clinic. Spirometry, including bronchodilator reversibility, skin prick test (SPT) and allergens specific IgE (sIgE) were done. Serum total IgE, exhaled nitric oxide (FeNO) and blood eosinophils were measured. HRCT was performed. History of tobacco smoking, pollution, biomass exposure and symptoms control score (ACT and CAT) were assessed. Patients were classified pure asthma, pure COPD and ACOS according to predefined definition of this study.

RESULTS: Total 92 consecutive patients were enrolled which comprised 58 patients with clinician diagnosed asthma with history of smoking or biomass exposure and 34 with clinician diagnosed COPD. Mean age was 67.4 years. Thirty-four (58.6%) asthma patients were considered to have ACOS if their postbronchodilator FEV1/FVC ratio <70% and/or presence of HRCT detected emphysema. In addition, 10 (28.6%) COPD patients were labelled ACOS if they had bronchodilator reversibility (FEV1≥ 12% and ≥ 200 ml from baseline). Hence, total of 44 from 92(47.3%) patients with obstructive airway diseases were found to have ACOS, while pure asthma and pure COPD were found in 24 patients equally. COPD patients were older and had more pack-years of tobacco smoking than those with asthma and ACOS (p=0.0001). Female gender was less common in COPD than ACOS and asthma (p=0.0001). Atopic status was common in asthma and ACOS but was not significantly different from COPD. There was no difference in symptom score assessed by CAT and ACT found between three groups of patients. Neither serum total IgE nor blood eosinophils distinguished ACOS from asthma and COPD (p=0.83 and p=0.40). FeNO level of patients with COPD was different from those with asthma and ACOS (p=0.04).

CONCLUSIONS: Prevalence of ACOS is common in severe late-onset asthma and COPD who have been treated in tertiary care hospital.

CLINICAL IMPLICATIONS: ACOS is common in clinical practice despite there is no established clinical definition. Atopy and systemic eosinophilia are not able to differentiate ACOS from pure COPD.

DISCLOSURE: The following authors have nothing to disclose: Theerasuk Kawamatawong, Sanruethai Charoenniwassakul, Ticha Rerkpattanapipat

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