Asthma features in severe COPD : Identifying treatable traits
Copyright © 2018. Published by Elsevier Ltd..
AIM: Biological therapies developed for severe asthma may have a role in COPD patients with asthma features.
METHOD: We carried out a prospective, consecutive, cross-sectional analysis of 80 patients with severe COPD GOLD IV/D.
RESULTS: We studied 80 patients (48.8% female), aged 57.6 ± 5.1 years, ex-smokers with 35.7 ± 21.2 pack years, BMI 22.3 ± 3.5 kg/m2, FEV1 of 0.61 ± 0.2 L (21.1 ± 5.6% pred), pO2 52.4 ± 8.4 mmHg, and BODE 6.9 ± 1.7. 68% had >2 moderate or severe exacerbations annually. 16.1% (5/31) patients showed FEV1 reversibility of >12% and >200 ml despite maximal therapy, 33% (15/45) had FENO ≥22.5 ppb, 33% (24/73) had serum IgE ≥100 I.E./ml and there was positive allergen sensitization in 51.5% (35/68). Blood eosinophilia of ≥150 cells/μl was seen in 47% (35/74). Induced sputum showed eosinophilia of ≥2% in 56% (14/24) with respiratory pathogens in 63.8% (30/47). We identified 12 (15%) patients with asthma-COPD overlap. Of these, 10 (83.3%) had frequent exacerbations and these patients had significantly more severe exacerbations requiring NIV or ICU than those without asthma features (p < 0.005).
CONCLUSION: We detected asthma features in a substantial subset of stable patients with severe COPD. Asthma features were associated with more severe exacerbation despite optimal COPD therapy, representing potential candidates for targeted therapy with anti- IgE or anti-IL5.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:145 |
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| Enthalten in: |
Respiratory medicine - 145(2018) vom: 07. Dez., Seite 89-94 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Matthes, Sandhya [VerfasserIn] |
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| Links: |
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| Themen: |
37341-29-0 |
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| Anmerkungen: |
Date Completed 08.10.2019 Date Revised 08.10.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.rmed.2018.10.027 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM291404863 |
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| 245 | 1 | 0 | |a Asthma features in severe COPD |b Identifying treatable traits |
| 264 | 1 | |c 2018 | |
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| 500 | |a Date Completed 08.10.2019 | ||
| 500 | |a Date Revised 08.10.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018. Published by Elsevier Ltd. | ||
| 520 | |a AIM: Biological therapies developed for severe asthma may have a role in COPD patients with asthma features | ||
| 520 | |a METHOD: We carried out a prospective, consecutive, cross-sectional analysis of 80 patients with severe COPD GOLD IV/D | ||
| 520 | |a RESULTS: We studied 80 patients (48.8% female), aged 57.6 ± 5.1 years, ex-smokers with 35.7 ± 21.2 pack years, BMI 22.3 ± 3.5 kg/m2, FEV1 of 0.61 ± 0.2 L (21.1 ± 5.6% pred), pO2 52.4 ± 8.4 mmHg, and BODE 6.9 ± 1.7. 68% had >2 moderate or severe exacerbations annually. 16.1% (5/31) patients showed FEV1 reversibility of >12% and >200 ml despite maximal therapy, 33% (15/45) had FENO ≥22.5 ppb, 33% (24/73) had serum IgE ≥100 I.E./ml and there was positive allergen sensitization in 51.5% (35/68). Blood eosinophilia of ≥150 cells/μl was seen in 47% (35/74). Induced sputum showed eosinophilia of ≥2% in 56% (14/24) with respiratory pathogens in 63.8% (30/47). We identified 12 (15%) patients with asthma-COPD overlap. Of these, 10 (83.3%) had frequent exacerbations and these patients had significantly more severe exacerbations requiring NIV or ICU than those without asthma features (p < 0.005) | ||
| 520 | |a CONCLUSION: We detected asthma features in a substantial subset of stable patients with severe COPD. Asthma features were associated with more severe exacerbation despite optimal COPD therapy, representing potential candidates for targeted therapy with anti- IgE or anti-IL5 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Asthma and COPD overlap | |
| 650 | 4 | |a COPD | |
| 650 | 4 | |a Exacerbations of COPD | |
| 650 | 4 | |a Targeted therapy | |
| 650 | 7 | |a Allergens |2 NLM | |
| 650 | 7 | |a Antibodies, Monoclonal |2 NLM | |
| 650 | 7 | |a IL5 protein, human |2 NLM | |
| 650 | 7 | |a Interleukin-5 |2 NLM | |
| 650 | 7 | |a Immunoglobulin E |2 NLM | |
| 650 | 7 | |a 37341-29-0 |2 NLM | |
| 700 | 1 | |a Stadler, Jakob |e verfasserin |4 aut | |
| 700 | 1 | |a Barton, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Leuschner, Gabriela |e verfasserin |4 aut | |
| 700 | 1 | |a Munker, Dieter |e verfasserin |4 aut | |
| 700 | 1 | |a Arnold, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Villena-Hermoza, Heidrun |e verfasserin |4 aut | |
| 700 | 1 | |a Frankenberger, Marion |e verfasserin |4 aut | |
| 700 | 1 | |a Probst, Philipp |e verfasserin |4 aut | |
| 700 | 1 | |a Koch, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Kneidinger, Nikolaus |e verfasserin |4 aut | |
| 700 | 1 | |a Milger, Katrin |e verfasserin |4 aut | |
| 700 | 1 | |a Behr, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Neurohr, Claus |e verfasserin |4 aut | |
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