Clinical characteristic of patients with COPD-A

Abstract Background The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) document proposed the COPD-A subtype as a condition of COPD with asthma. We examined the characteristics of COPD-A patients and analyzed them according to smoking history and inhaled corticosteroid (ICS) use....

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Main Authors: Jong Min Lee, Youlim Kim, Joon Young Choi, Seung Won Ra, Deog Kyeom Kim, Tae-Hyung Kim, Hyung Kyu Yoon, Kwang Ha Yoo, Ki-Suck Jung, Chin Kook Rhee
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03731-9
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Summary:Abstract Background The 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) document proposed the COPD-A subtype as a condition of COPD with asthma. We examined the characteristics of COPD-A patients and analyzed them according to smoking history and inhaled corticosteroid (ICS) use. Methods Patients in the COPD cohort with a history of asthma were included. The patients were divided into two groups according to their smoking history (< 10 vs. ≥10 pack-years) and their clinical characteristics were compared. The association between patients’ ICS use and the occurrence for exacerbations during 1 year follow-up period was analyzed. Results Of the 970 patients included in the analysis, the group with a smoking history less than 10 pack-years (n = 158) had a significantly higher BMI, FEV1 (%), FEV1/FVC (%), DLco, ESR, and prevalence of osteoporosis. Among 560 patients who were followed up for 1 year, the patients with ICS (n = 274) had a higher exacerbation rate than without ICS (n = 286) (54% vs. 44.1%, p = 0.018). However, in multivariable analysis, ICS use was not significantly associated with exacerbation. In subgroup analysis of patients with blood eosinophil count ≥ 300 cells/µl, ICS use showed a trend to reduce the risk for exacerbation (IRR = 0.907, p = 0.708). In patients with blood eosinophil count < 300 cells/µl, ICS use significantly increased the risk for exacerbation (IRR = 1.547, p = 0.005). Conclusions COPD-A patients with a smoking history of less than 10 pack-years had better pulmonary function test results, BMI, ESR, and prevalence of osteoporosis. The use of ICS did not decrease exacerbations in COPD-A.
ISSN:1471-2466