Asthma-chronic obstructive pulmonary disease overlap: Results from a national-multicenter study

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Epidemiology

Background:

• Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents a significant clinical challenge with a higher disease burden compared to asthma or COPD alone.
• Limited national data exists regarding the prevalence and characteristics of ACO in Türkiye.
• Understanding ACO is crucial for effective patient management and resource allocation.

Purpose of the Study:

• To determine the prevalence of ACO in patients diagnosed with asthma or COPD in Türkiye.
• To identify risk factors associated with ACO.
• To describe the clinical features and disease progression in patients with ACO.

Main Methods:

• A cross-sectional study was conducted across nine tertiary-care hospitals in Türkiye.
• Patients with a diagnosis of asthma or COPD for at least one year were enrolled.
• Data on patient demographics, medical history, clinical features, and lung function (FEV1 decline) were collected and analyzed.

Main Results:

• The overall prevalence of ACO was 20.8% (85 out of 408 subjects).
• ACO was more frequent in the COPD group (33.3%) than in the asthma group (9.8%).
• ACO patients shared features with both COPD (advanced age, smoking, rural background) and asthma (childhood asthma history, allergies, high eosinophils), and exhibited a more pronounced annual decline in FEV1 (-250 mL).

Conclusions:

• Asthma-COPD overlap (ACO) is prevalent in tertiary care settings in Türkiye.
• ACO patients exhibit a distinct phenotype with characteristics of both asthma and COPD.
• Clinicians should consider ACO in patients presenting with overlapping symptoms of asthma and COPD.