Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap

Background: This study examined the differences in the prevalence and clinical features of asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) with identical diagnostic criteria by race and ethnicity in two nationwide cohorts of COPD.Methods: We used data from the Korean COPD Subgroup...

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Autores principales:	Yong Suk Jo, Yong Il Hwang, Kwang Ha Yoo, Myung Goo Lee, Ki Suck Jung, Kyeong-Cheol Shin, Hyoung Kyu Yoon, Deog Kyeom Kim, Sang Yeub Lee, Chin Kook Rhee
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	ACO asthma–COPD overlap COPDGene (UA Genetic Epidemiology of COPD) KOCOSS (Korean COPD Subgroup Study) racial and ethnic differences inhaled corticosteroid (ICS) Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b061edc737004e969fcec66c1db8e0d3
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spelling	oai:doaj.org-article:b061edc737004e969fcec66c1db8e0d32021-11-22T04:30:33ZRacial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap2296-858X10.3389/fmed.2021.780438https://doaj.org/article/b061edc737004e969fcec66c1db8e0d32021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.780438/fullhttps://doaj.org/toc/2296-858XBackground: This study examined the differences in the prevalence and clinical features of asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) with identical diagnostic criteria by race and ethnicity in two nationwide cohorts of COPD.Methods: We used data from the Korean COPD Subgroup Study (KOCOSS) and phase I of the US Genetic Epidemiology of COPD (COPDGene) study. We defined ACO by satisfying bronchodilator response (BDR) >15% and 400 ml and/or blood eosinophil count ≥300/μl.Results: The prevalences of ACO according to ethnicity were non-Hispanic white (NHW), 21.4%; African American (AA), 17.4%; and Asian, 23.8%. Asian patients with ACO were older, predominantly male, with fewer symptoms, more severe airflow limitation, and fewer comorbidities than NHW and AA patients. During 1-year follow-up, exacerbations occurred in 28.2, 22.0, and 48.4% of NHW, AA, and Asian patients with ACO, respectively. Compared to patients with non-ACO from the same racial group, the risk for exacerbation was significantly higher in NHW and Asian patients with ACO [adjusted incident rate ratio (aIRR), 1.17; 95% CI, 1.01–1.36, and aIRR, 1.37; 95% CI, 1.09–1.71 for NHW and Asian patients with ACO, respectively]. Inhaled corticosteroid (ICS) reduced the risk for future exacerbation in total patients with ACO but the effect was not significant in each racial group.Conclusions: The prevalence of ACO was similar in the two cohorts using the same diagnostic criteria. The risk for future exacerbation was significantly higher in ACO, and the use of ICS reduced the risk for exacerbation in total patients with ACO.Yong Suk JoYong Il HwangKwang Ha YooMyung Goo LeeKi Suck JungKyeong-Cheol ShinHyoung Kyu YoonDeog Kyeom KimSang Yeub LeeChin Kook RheeFrontiers Media S.A.articleACOasthma–COPD overlapCOPDGene (UA Genetic Epidemiology of COPD)KOCOSS (Korean COPD Subgroup Study)racial and ethnic differencesinhaled corticosteroid (ICS)Medicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ACO asthma–COPD overlap COPDGene (UA Genetic Epidemiology of COPD) KOCOSS (Korean COPD Subgroup Study) racial and ethnic differences inhaled corticosteroid (ICS) Medicine (General) R5-920
spellingShingle	ACO asthma–COPD overlap COPDGene (UA Genetic Epidemiology of COPD) KOCOSS (Korean COPD Subgroup Study) racial and ethnic differences inhaled corticosteroid (ICS) Medicine (General) R5-920 Yong Suk Jo Yong Il Hwang Kwang Ha Yoo Myung Goo Lee Ki Suck Jung Kyeong-Cheol Shin Hyoung Kyu Yoon Deog Kyeom Kim Sang Yeub Lee Chin Kook Rhee Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap
description	Background: This study examined the differences in the prevalence and clinical features of asthma–chronic obstructive pulmonary disease (COPD) overlap (ACO) with identical diagnostic criteria by race and ethnicity in two nationwide cohorts of COPD.Methods: We used data from the Korean COPD Subgroup Study (KOCOSS) and phase I of the US Genetic Epidemiology of COPD (COPDGene) study. We defined ACO by satisfying bronchodilator response (BDR) >15% and 400 ml and/or blood eosinophil count ≥300/μl.Results: The prevalences of ACO according to ethnicity were non-Hispanic white (NHW), 21.4%; African American (AA), 17.4%; and Asian, 23.8%. Asian patients with ACO were older, predominantly male, with fewer symptoms, more severe airflow limitation, and fewer comorbidities than NHW and AA patients. During 1-year follow-up, exacerbations occurred in 28.2, 22.0, and 48.4% of NHW, AA, and Asian patients with ACO, respectively. Compared to patients with non-ACO from the same racial group, the risk for exacerbation was significantly higher in NHW and Asian patients with ACO [adjusted incident rate ratio (aIRR), 1.17; 95% CI, 1.01–1.36, and aIRR, 1.37; 95% CI, 1.09–1.71 for NHW and Asian patients with ACO, respectively]. Inhaled corticosteroid (ICS) reduced the risk for future exacerbation in total patients with ACO but the effect was not significant in each racial group.Conclusions: The prevalence of ACO was similar in the two cohorts using the same diagnostic criteria. The risk for future exacerbation was significantly higher in ACO, and the use of ICS reduced the risk for exacerbation in total patients with ACO.
format	article
author	Yong Suk Jo Yong Il Hwang Kwang Ha Yoo Myung Goo Lee Ki Suck Jung Kyeong-Cheol Shin Hyoung Kyu Yoon Deog Kyeom Kim Sang Yeub Lee Chin Kook Rhee
author_facet	Yong Suk Jo Yong Il Hwang Kwang Ha Yoo Myung Goo Lee Ki Suck Jung Kyeong-Cheol Shin Hyoung Kyu Yoon Deog Kyeom Kim Sang Yeub Lee Chin Kook Rhee
author_sort	Yong Suk Jo
title	Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap
title_short	Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap
title_full	Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap
title_fullStr	Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap
title_full_unstemmed	Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap
title_sort	racial differences in prevalence and clinical characteristics of asthma–chronic obstructive pulmonary disease overlap
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b061edc737004e969fcec66c1db8e0d3
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Racial Differences in Prevalence and Clinical Characteristics of Asthma–Chronic Obstructive Pulmonary Disease Overlap

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