Cecilia Brown

DocwireNews

Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap have distinct features compared with patients with asthma or COPD alone, according to a recent study.Junjie Peng, of West China School of Medicine at Sichuan University, and colleagues conducted the study to evaluate the diagnostic value of indicators for asthma-COPD overlap.They performed the research because &ldquo;some clinical indicators have been reported to be useful in differentiating asthma-chronic obstructive pulmonary disease overlap from pure asthma/COPD, but the results were inconsistent,&rdquo; according to the authors.The investigators searched the PubMed, EMBASE, Ovid, and Web of Science databases and found 48 studies eligible for inclusion in the analysis.Patients with asthma-COPD overlap had lower predicted percentages of forced expiratory volume in the first second than patients with asthma alone (standardized mean difference [SMD], &minus;1.09; 95% CI, &minus;1.3 to &minus;0.87). Patients with asthma-COPD overlap also had lower predicted percentages of diffusion lung capacity for carbon monoxide (SMD, &minus;0.83; 95% CI, &minus;1.24 to &minus;0.42) and fractional exhaled nitric oxide (SMD, &minus;0.23; 95% CI, &minus;0.36 to &minus;0.11) than patients with asthma alone. However, patients with asthma-COPD overlap had higher levels of induced sputum neutrophil (SMD, 0.51; 95% CI, 0.21 to 0.81) and circulating YKL-40 (SMD, 0.96; 95% CI, 0.27 to 1.64) than patients with asthma alone.Patients with asthma-COPD overlap had higher predicted percentages of forced expiratory volume in the first second (SMD, 0.15; 95% CI, 0.05 to 0.26) and higher predicted percentages of diffusion lung capacity for carbon monoxide (SMD, 0.38; 95% CI, 0.16 to 0.6) than patients with COPD alone. Those with asthma-COPD overlap also had higher levels of fractional exhaled nitric oxide (SMD, 0.59; 95% CI, 0.40 to 0.78), serum total immunoglobulin (Ig) E (SMD, 0.42; 95% CI, 0.1 to 0.75), blood eosinophils (SMD, 0.44; 95% CI, 0.29 to 0.59), and induced sputum eosinophil (SMD, 0.62; 95% CI, 0.42 to 0.83) than patients with COPD alone. However, patients with asthma-COPD overlap had lower levels of induced sputum neutrophil (SMD, &minus;0.48; 95% CI, &minus;0.7 to &minus;0.27) and circulating YKL-40 (SMD, &minus;1.09; 95% CI, &minus;1.92 to &minus;0.26) than patients with COPD alone.&ldquo;Compared with pure asthma/COPD, patients [with asthma-COPD overlap] have different levels of [predicted percentages of forced expiratory volume in the first second], [predicted percentages of diffusion lung capacity for carbon monoxide], [fractional exhaled nitric oxide], serum total IgE, blood eosinophil, induced sputum eosinophil/neutrophil, and circulating YKL-40, which could be helpful to establish a clinical diagnosis of [asthma-COPD overlap],&rdquo; the researchers concluded.Peng J, Wang M, Wu Y, Shen Y, Chen L. Clinical indicators for asthma-COPD overlap: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2022;17:2567-2575. doi:10.2147/COPD.S374079

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Characteristics Distinguish Asthma-COPD From Pure Asthma or COPD

Asthma

Patients with asthma-chronic obstructive pulmonary disease (COPD) overlap have distinct features compared with patients with asthma or COPD alone, according to a recent ...

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