COPD Patients with Asthma Features in Vietnam: Prevalence and Suitability for Personalized Medicine
Abstract
:1. Introduction
2. Patients and Methods
2.1. Study Design
2.2. Patients
2.3. Data Collection
2.4. Diagnosing COPD Patients with Asthma Features
2.5. Statistical Analysis
3. Results
3.1. The Proportion of COPD Patients with Asthma Features
3.2. Characteristics of COPD Patients with Asthma Features
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Features | COPD with Asthma Features * (n = 82) | COPD Alone * (n = 218) | p-Value |
---|---|---|---|
Features that favor asthma | |||
Symptoms vary over time | 43 (52.4%) | 40 (18.4%) | <0.001 |
Symptoms vary seasonally | 19 (23.2%) | 9 (4.1%) | <0.001 |
Symptoms worsen during the night or early morning | 42 (51.2%) | 18 (8.3%) | <0.001 |
Symptoms are triggered by exercise, emotional change, or exposure to dust/allergens | 42 (51.2%) | 23 (10.6%) | <0.001 |
Symptoms do not worsen over time | 17 (20.7%) | 3 (1.4%) | <0.001 |
Symptoms improve spontaneously | 16 (19.5%) | 15 (6.9%) | 0.002 |
Symptoms improve over weeks with ICS treatment | 37 (45.2%) | 15 (6.9%) | <0.001 |
Record of reversible airflow limitation | 4 (4.9%) | 12 (5.5%) | 0.828 |
Allergic rhinitis | 13 (15.9%) | 3 (1.4%) | <0.001 |
Physician-diagnosed asthma | 28 (34.1%) | 6 (2.8%) | <0.001 |
Family history of asthma | 9 (11.0%) | 7 (3.2%) | 0.016 |
Features that favor COPD | |||
Symptoms onset after 40 years old | 68 (89.5%) | 207 (97.6%) | 0.006 |
Symptoms persist despite treatment | 33 (40.2%) | 146 (67.0%) | <0.001 |
Good/bad days but symptoms are observed on a daily basis | 22 (26.8%) | 130 (59.6%) | <0.001 |
Chronic cough and sputum precede onset of dyspnea and are unrelated to triggers | 40 (48.8%) | 159 (72.9%) | <0.001 |
Symptoms slowly worsen over time | 52 (63.4%) | 181 (83.0%) | <0.001 |
Rapid-acting bronchodilator treatment provides only limited relief | 34 (41.5%) | 118 (54.1%) | 0.050 |
Record of persistent airflow limitation | 80 (97.6%) | 213 (97.7%) | 0.941 |
Abnormal lung function between symptoms | (n = 52) 52 (100.0%) | (n = 117) 111 (94.9%) | 0.034 |
Hyperinflation on chest X-ray | (n = 52) 21 (40.4%) | (n = 73) 45 (31.0%) | 0.225 |
Characteristics | Total (n = 300) | COPD with Asthma Features * (n = 82) | COPD Alone * (n = 218) | p-Value |
---|---|---|---|---|
Age (years) | 65.0 ± 9.7 | 62.7 ± 10.6 | 65.8 ± 9.2 | 0.021 |
Age at symptoms onset (years) | 60.5 ± 12.2 | 56.0 ± 15.8 | 62.1 ± 10.2 | 0.004 |
Female | 24 (8.0%) | 14 (17.1%) | 10 (4.6%) | <0.001 |
Weight (kg) | 55.4 ± 9.7 | 55.9 ± 8.8 | 55.2 ± 10.0 | 0.572 |
Height (cm) | 160.1 ± 6.7 | 159.7 ± 6.8 | 160.2 ± 6.6 | 0.585 |
BMI (kg/m2) | 21.6 ± 3.6 | 21.9 ± 3.4 | 21.5 ± 3.6 | 0.345 |
Current smoker | 53 (17.7%) | 15 (18.3%) | 38 (17.4%) | <0.001 |
Ex-smoker | 202 (67.3%) | 40 (48.8%) | 162 (74.3%) | |
Non-smoker | 45 (15.0%) | 27 (32.9%) | 18 (8.3%) | |
Pack-years | (n = 237) 33.7 ± 17.9 | (n = 53) 34.0 ± 18.7 | (n = 184) 33.6 ± 17.7 | 0.884 |
Comorbidities | ||||
Hypertension | 56 (18.7%) | 16 (19.5%) | 40 (18.4%) | 0.818 |
Allergic rhinitis | 16 (5.5%) | 13 (15.9%) | 3 (1.4%) | <0.001 |
GERD | 16 (5.5%) | 4 (4.9%) | 12 (5.5%) | 0.828 |
Ischemic heart disease | 14 (4.7%) | 4 (4.9%) | 10 (4.6%) | 0.916 |
Diabetes mellitus | 10 (3.3%) | 2 (2.4%) | 8 (3.7%) | 0.585 |
Characteristics | Total (n = 300) | COPD with Asthma Features * (n = 82) | COPD Alone * (n = 218) | p-Value |
---|---|---|---|---|
≥1 exacerbation in the previous year | 90 (30.0%) | 22 (26.8%) | 68 (31.2%) | 0.459 |
≥2 exacerbations in the previous year | 45 (15.0%) | 8 (9.8%) | 37 (17.0%) | 0.106 |
≥1 hospitalization in the previous year | 45 (15.0%) | 11 (13.4%) | 34 (15.6%) | 0.634 |
CAT | (n = 181) 16.0 ± 6.3 | (n = 45) 14.8 ± 5.6 | (n = 136) 16.4 ± 6.5 | 0.111 |
CAT ≥ 10 | 151 (83.4%) | 37 (82.2%) | 114 (83.8%) | 0.804 |
mMRC | (n = 179) 2 (2; 3) | (n = 54) 2 (2; 3) | (n = 125) 2 (2; 3) | 0.091 |
mMRC ≥ 2 | 143 (79.9%) | 42 (77.8%) | 101 (80.8%) | 0.646 |
Blood eosinophil count (per µL) | (n = 36) 190 (102.5; 297.5) | (n = 10) 310 (162.5; 650) | (n = 26) 145 (100; 215) | 0.016 |
Blood eosinophil percent | 2.3% (1.2%; 3.8%) | 4.4% (2.2%; 6.7%) | 1.9% (1.0%; 2.8%) | 0.004 |
Blood eosinophil ≥ 300/ µL | 9 (25.0%) | 5 (50.0%) | 4 (15.4%) | 0.038 |
Blood eosinophil ≥ 3% | 12 (33.3%) | 7 (70.0%) | 5 (19.2%) | 0.007 |
Characteristics | Total | COPD with Asthma Features * | COPD Alone * | p-Value |
---|---|---|---|---|
Latest spirometric measurement | ||||
(n = 201) | (n = 54) | (n = 147) | ||
% post-BD FEV1 | 54.6 ± 18.1 | 61.7 ± 16.1 | 52.0 ± 18.2 | <0.001 |
% post-BD FVC | 74.2 ± 16.8 | 80.8 ± 14.4 | 71.8 ± 17.0 | <0.001 |
Post-BD FEV1/FVC | 53.6 ± 11.6 | 57.4 ± 8.4 | 52.2 ± 12.3 | <0.001 |
Bronchodilator reversibility at the first spirometric measurement | ||||
(n = 284) | (n = 77) | (n = 207) | ||
FEV1 change (mL) | 80 (20; 170) | 120 (50; 215) | 70 (20; 150) | 0.001 |
%FEV1 change (%) | 7.9 (2.1; 15.7) | 11.8 (2.7; 21.6) | 7.0 (1.7; 14.2) | 0.014 |
FEV1 increase ≥200 mL and ≥12% | 45 (15.8%) | 24 (31.2%) | 21 (10.1%) | <0.001 |
FEV1 increase ≥400 mL and ≥15% | 7 (2.5%) | 5 (6.5%) | 2 (1.0%) | 0.017 |
FEV1 change between the best and worst measurements during 3 years of follow up | ||||
(n = 117) | (n = 36) | (n = 81) | ||
Pre-BD FEV1 change (mL) | 240 (85; 420) | 300 (170; 600) | 200 (75; 355) | 0.012 |
% pre-BD FEV1 change (%) | 8 (3; 17) | 10 (4; 24) | 7.0 (3; 15.5) | 0.298 |
FEV1 increase ≥200 mL and ≥12% | 45 (38.5%) | 16 (44.4%) | 29 (35.8%) | 0.377 |
FEV1 increase ≥400 mL and ≥15% | 22 (18.8%) | 11 (30.6%) | 11 (13.6%) | 0.035 |
Medications | Total (n = 300) | COPD with Asthma Features * (n = 82) | COPD Alone * (n = 218) | p-Value |
---|---|---|---|---|
LABA † | 42 (14.0%) | 6 (7.3%) | 36 (16.5%) | 0.031 |
LAMA | 104 (34.7%) | 24 (29.3%) | 80 (36.7%) | 0.224 |
LABA/ICS ‡ | 240 (80.0%) | 73 (89.0%) | 167 (76.6%) | 0.012 |
LABA/ICS + LAMA § | 70 (23.3%) | 20 (24.4%) | 50 (22.9%) | 0.791 |
LTRA | 50 (16.7%) | 25 (30.5%) | 25 (11.5%) | <0.001 |
Theophylline | 92 (30.7%) | 14 (17.1%) | 78 (35.8%) | 0.001 |
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Van Tho, N.; Phan, T.P.; Dinh-Xuan, A.T.; Ngo, Q.C.; Lan, L.T.T. COPD Patients with Asthma Features in Vietnam: Prevalence and Suitability for Personalized Medicine. J. Pers. Med. 2023, 13, 901. https://doi.org/10.3390/jpm13060901
Van Tho N, Phan TP, Dinh-Xuan AT, Ngo QC, Lan LTT. COPD Patients with Asthma Features in Vietnam: Prevalence and Suitability for Personalized Medicine. Journal of Personalized Medicine. 2023; 13(6):901. https://doi.org/10.3390/jpm13060901
Chicago/Turabian StyleVan Tho, Nguyen, Thu Phuong Phan, Anh Tuan Dinh-Xuan, Quy Chau Ngo, and Le Thi Tuyet Lan. 2023. "COPD Patients with Asthma Features in Vietnam: Prevalence and Suitability for Personalized Medicine" Journal of Personalized Medicine 13, no. 6: 901. https://doi.org/10.3390/jpm13060901