Asthma-COPD Overlap Decreases Life Expectancy, Lung Function

Individuals with chronic obstructive pulmonary disease (COPD) who were diagnosed with asthma after age 40 years have a significantly higher risk of hospitalization and death and have a shorter life expectancy than those with COPD who were diagnosed with asthma before the age of 40 years, according to new research.

Although asthma-COPD overlap is common, prognosis associated with the conditions is poorly described. The researchers aimed to investigate the long-term prognosis of individuals with chronic airway diseases, specifically those with asthma-COPD overlap.
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To conduct their study, the researchers followed 8382 participants in the Copenhagen City Heart Study in Denmark.

The participants were separated into 6 groups: healthy never-smokers (2199), ever-smokers without asthma and COPD (5435), those with asthma with low cumulated smoking exposure and no airflow limitation (158), those with COPD (320), those with asthma-COPD overlap with asthma onset before the age of 40 years (68), and those with asthma-COPD overlap with asthma onset after the age of 40 years (202)

The researchers evaluated participants’ forced expiratory volume in 1 second (FEV₁) over 18 years and their risk of hospital admission due to exacerbations or pneumonias, and respiratory and all-cause mortality over 22 years.

After analyzing the data, the researchers found that participants with asthma-COPD overlap and late-onset asthma had the highest FEV₁ decline at 49.6 mL per year, were most likely to visit the hospital due to exacerbations of asthma or COPD, and had the shortest life expectancy at 12.8 years shorter than healthy never-smokers.

“Prognosis of individuals with asthma-COPD overlap is poor and seems to be affected by the age of recognition of asthma, being worst in those with late asthma onset (after 40 years of age),” the researchers concluded. “Such patients should be followed up closely to prevent fast lung function decline and exacerbations.”

—Amanda Balbi

Reference:

Lange P, Çolak Y, Ingebrigtsen TS, Vestbo J, Marott JL. Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study: a prospective population-based analysis [published online April 6, 2016]. Lancet Respir Med. doi:http://dx.doi.org/10.1016/S2213-2600(16)00098-9.