Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort

Abstract Background Many studies explored the features of Chronic obstructive pulmonary disease (COPD) with asthma-like features. We aimed to compare the exacerbation and mortality during one-year follow-up among COPD patients with asthma-like features with different inhalation therapies in the Chin...

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Main Authors: Ling Lin, Wei Cheng, Qing Song, Tao Li, Cong Liu, Ping Zhang, Yuqin Zeng, Dingding Deng, Zhiping Yu, Yan Chen, Ping Chen
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-025-03767-x
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author Ling Lin
Wei Cheng
Qing Song
Tao Li
Cong Liu
Ping Zhang
Yuqin Zeng
Dingding Deng
Zhiping Yu
Yan Chen
Ping Chen
author_facet Ling Lin
Wei Cheng
Qing Song
Tao Li
Cong Liu
Ping Zhang
Yuqin Zeng
Dingding Deng
Zhiping Yu
Yan Chen
Ping Chen
author_sort Ling Lin
collection DOAJ
description Abstract Background Many studies explored the features of Chronic obstructive pulmonary disease (COPD) with asthma-like features. We aimed to compare the exacerbation and mortality during one-year follow-up among COPD patients with asthma-like features with different inhalation therapies in the Chinese population (compare Without-inhaled corticosteroids(ICS)and With-ICS inhalation therapy, and then ICS + long-acting β-2-agonist(LABA) and ICS + LABA + long-acting muscarinic antagonists (LAMA). Methods This real-world observational study was conducted in the RealDTC cohort (ChiCTR-POC-17010431, Trial Regisrtation Date: 2017.01.14). COPD patients with asthma-like features in China from July 1, 2017, to June 31 2022 were recruited into the study and followed-up for 12 months. The Without-ICS inhalation therapy cohort included patients with LAMA or LABA + LAMA therapy, the With-ICS inhalation therapy cohort included patients with ICS + LABA or ICS + LABA + LAMA therapy. Results Of the 2735 eligible participants, the With-ICS inhalation therapy cohort was less likely to experience moderate-to-severe exacerbation and severe exacerbation during follow-up than the Without-ICS inhalation therapy cohort after PSM in multivariate analysis, but not death. The ICS + LABA + LAMA group had a lower risk of moderate-to-severe and frequent exacerbations than the ICS + LABA group after PSM. In addition, patients with CAT ≥ 10, or with previous exacerbation history, or with GOLD II and GOLD III + IV grade, receiving ICS + LABA + LAMA had a decreased risk of exacerbation compared to ICS + LABA. Conclusions COPD patients with asthma-like features with With-ICS inhalation therapy based on bronchodilators were less likely to experience future exacerbations than those Without-ICS inhalation therapy, but not death. In addition, ICS + LABA + LAMA therapy decreased the risk of exacerbation compared to ICS + LABA therapy during follow-up, especially in patients with CAT ≥ 10, or with previous exacerbation history, or with GOLD II and GOLD III + IV grade.
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spelling doaj-art-96e7d0006eba45e9bbfc764ef58464d92025-08-20T04:01:24ZengBMCBMC Pulmonary Medicine1471-24662025-07-0125111110.1186/s12890-025-03767-xComparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohortLing Lin0Wei Cheng1Qing Song2Tao Li3Cong Liu4Ping Zhang5Yuqin Zeng6Dingding Deng7Zhiping Yu8Yan Chen9Ping Chen10Department of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Pulmonary and Critical Care Medicine, Xiangya Hospital, Central South UniversityDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Respiratory Medicine, The First Affiliated People’s Hospital Shaoyang CollegeDepartment of Respiratory and Critical Care Medicine, Traditional Chinese Medicine of Longshan HospitalDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityDepartment of Respiratory and Critical Care Medicine, Second Xiangya Hospital, Central South UniversityAbstract Background Many studies explored the features of Chronic obstructive pulmonary disease (COPD) with asthma-like features. We aimed to compare the exacerbation and mortality during one-year follow-up among COPD patients with asthma-like features with different inhalation therapies in the Chinese population (compare Without-inhaled corticosteroids(ICS)and With-ICS inhalation therapy, and then ICS + long-acting β-2-agonist(LABA) and ICS + LABA + long-acting muscarinic antagonists (LAMA). Methods This real-world observational study was conducted in the RealDTC cohort (ChiCTR-POC-17010431, Trial Regisrtation Date: 2017.01.14). COPD patients with asthma-like features in China from July 1, 2017, to June 31 2022 were recruited into the study and followed-up for 12 months. The Without-ICS inhalation therapy cohort included patients with LAMA or LABA + LAMA therapy, the With-ICS inhalation therapy cohort included patients with ICS + LABA or ICS + LABA + LAMA therapy. Results Of the 2735 eligible participants, the With-ICS inhalation therapy cohort was less likely to experience moderate-to-severe exacerbation and severe exacerbation during follow-up than the Without-ICS inhalation therapy cohort after PSM in multivariate analysis, but not death. The ICS + LABA + LAMA group had a lower risk of moderate-to-severe and frequent exacerbations than the ICS + LABA group after PSM. In addition, patients with CAT ≥ 10, or with previous exacerbation history, or with GOLD II and GOLD III + IV grade, receiving ICS + LABA + LAMA had a decreased risk of exacerbation compared to ICS + LABA. Conclusions COPD patients with asthma-like features with With-ICS inhalation therapy based on bronchodilators were less likely to experience future exacerbations than those Without-ICS inhalation therapy, but not death. In addition, ICS + LABA + LAMA therapy decreased the risk of exacerbation compared to ICS + LABA therapy during follow-up, especially in patients with CAT ≥ 10, or with previous exacerbation history, or with GOLD II and GOLD III + IV grade.https://doi.org/10.1186/s12890-025-03767-xCOPD with asthma-like featureDifferent inhalation therapiesInhaled corticosteroidsExacerbationMortality
spellingShingle Ling Lin
Wei Cheng
Qing Song
Tao Li
Cong Liu
Ping Zhang
Yuqin Zeng
Dingding Deng
Zhiping Yu
Yan Chen
Ping Chen
Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort
BMC Pulmonary Medicine
COPD with asthma-like feature
Different inhalation therapies
Inhaled corticosteroids
Exacerbation
Mortality
title Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort
title_full Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort
title_fullStr Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort
title_full_unstemmed Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort
title_short Comparison of clinical outcome of COPD with asthma-like feature with different inhalation therapies: a real-world study in the prospective RealDTC cohort
title_sort comparison of clinical outcome of copd with asthma like feature with different inhalation therapies a real world study in the prospective realdtc cohort
topic COPD with asthma-like feature
Different inhalation therapies
Inhaled corticosteroids
Exacerbation
Mortality
url https://doi.org/10.1186/s12890-025-03767-x
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