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Background <p>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.</p> Methods <p>Patients in the COPD cohort with a history of asthma were included. The patients were divided into two groups according to their smoking history (&lt; 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.</p> Results <p>Of the 970 patients included in the analysis, the group with a smoking history less than 10 pack-years (<i>n</i> = 158) had a significantly higher BMI, FEV<sub>1</sub> (%), FEV<sub>1</sub>/FVC (%), DLco, ESR, and prevalence of osteoporosis. Among 560 patients who were followed up for 1 year, the patients with ICS (<i>n</i> = 274) had a higher exacerbation rate than without ICS (<i>n</i> = 286) (54% vs. 44.1%, <i>p</i> = 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, <i>p</i> = 0.708). In patients with blood eosinophil count &lt; 300 cells/µl, ICS use significantly increased the risk for exacerbation (IRR = 1.547, <i>p</i> = 0.005).</p> Conclusions <p>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.</p>

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Clinical characteristic of patients with COPD-A

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月23日

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  • 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

摘要

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.