Patients with COPD and late-onset asthma have a greater risk of death and hospitalization than early-onset asthma patients with COPD, according to new research. COPD-asthma overlap was associated with a worse prognosis than COPD alone in the analysis of data from the Copenhagen City Heart Study, as indicated in a MedPage Today news report. However, patients with COPD-asthma overlap whose asthma occurred after age 40 had a notably more rapid decline in lung function, which was measured by one-second forced expiratory volume (FEV1), and worse survival, than patients whose asthma occurred before this age.
The researchers included 8,382 participants from the Copenhagen City Heart Study in the analysis, which included 5,435 ever-smokers, 2,199 never-smokers, 320 with COPD, 158 patients with asthma, 68 with asthma-COPD overlap with early-onset asthma, and 202 with asthma-COPD overlap with late-onset asthma. The researchers examined the course of FEV1 decline for 18 years and the risk of hospital admission due to exacerbations and pneumonias as well as respiratory and all-cause mortality for 22 years using a linear mixed-effects model.
In COPD patients with late-onset asthma, the rate of FEV1 decline was 82% faster than in those with early-onset asthma, and the survival was, on average, 13 years shorter than never-smoker controls, compared with 9 years shorter in patients with COPD-asthma overlap with early-onset asthma, according to MedPage Today. The results of the analysis also showed that FEV1 decline in those with asthma-COPD overlap with late-onset asthma was 49.6 mL per year, which was higher than declines observed in asthma-COPD overlap with early-onset asthma.
The analysis also revealed that hazard ratios for hospital admissions due to exacerbations of asthma or COPD were 39.48 in asthma-COPD overlap with early-onset asthma as compared to 83.47 in asthma-COPD overlap with late-onset asthma. In addition, life expectancy was 9.3 years shorter in patients with asthma-COPD overlap with early-onset asthma compared to 12.8 years shorter in those with asthma-COPD overlap with late-onset asthma.
“The major new finding of this study is that the long-term prognosis of patients sharing characteristics of both asthma and COPD is affected by the age of recognition of asthma,” the researchers write. “This study also highlights that individuals with asthma-COPD overlap with late-onset asthma are more susceptible to rapid deterioration of FEV1 and have a higher risk of acute hospital admissions due to respiratory diseases than individuals with COPD only.”
Source: MedPage Today