Matthes, Sandhya ORCID: 0000-0002-5227-0112, Stadler, Jakob, Barton, Juergen, Leuschner, Gabriela, Munker, Dieter, Arnold, Paola, Villena-Hermoza, Heidrun, Frankenberger, Marion, Probst, Philipp, Koch, Andrea, Kneidinger, Nikolaus ORCID: 0000-0001-7583-0453, Milger, Katrin ORCID: 0000-0003-2914-8773, Behr, Juergen and Neurohr, Claus (2018). Asthma features in severe COPD: Identifying treatable traits. Respir. Med., 145. S. 89 - 95. LONDON: W B SAUNDERS CO LTD. ISSN 1532-3064

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Abstract

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/m(2), FEV1 of 0.61 +/- 0.2 L (21.1 +/- 5.6% pred), pO(2) 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/mu l 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Matthes, SandhyaUNSPECIFIEDorcid.org/0000-0002-5227-0112UNSPECIFIED
Stadler, JakobUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barton, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Leuschner, GabrielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Munker, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnold, PaolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Villena-Hermoza, HeidrunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frankenberger, MarionUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Probst, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koch, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kneidinger, NikolausUNSPECIFIEDorcid.org/0000-0001-7583-0453UNSPECIFIED
Milger, KatrinUNSPECIFIEDorcid.org/0000-0003-2914-8773UNSPECIFIED
Behr, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neurohr, ClausUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-164336
DOI: 10.1016/j.rmed.2018.10.027
Journal or Publication Title: Respir. Med.
Volume: 145
Page Range: S. 89 - 95
Date: 2018
Publisher: W B SAUNDERS CO LTD
Place of Publication: LONDON
ISSN: 1532-3064
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OBSTRUCTIVE PULMONARY-DISEASE; OVERLAP SYNDROME; BLOOD EOSINOPHILS; EXACERBATIONS; SPUTUM; INFLAMMATIONMultiple languages
Cardiac & Cardiovascular Systems; Respiratory SystemMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/16433

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