Phenotyping chronic respiratory diseases with airways obstruction

• Published in: The international journal of tuberculosis and lung disease Vol. 28; no. 6; p. 287
• Main Authors: Nguyen, T C, Tran, H V T, Tran, M H T, Godin, I, Michel, O
• Format: Journal Article
• Language: English
• Published: France 01.06.2024
• Subjects: Adult; Aged; Asthma - diagnosis; Asthma - epidemiology; Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome - diagnosis; Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome - epidemiology; Female; Humans; Male; Middle Aged; Phenotype; Prevalence; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - epidemiology; Skin Tests; Vietnam - epidemiology; Vietnam
• ISSN: 1815-7920
• DOI: 10.5588/ijtld.23.0383

BACKGROUNDGiven the high prevalence of asthma-chronic obstructive pulmonary disease overlap (ACO) in Vietnam, there is an urgent need to establish a simplified strategy for categorising patients as either having asthma or chronic obstructive pulmonary disease (COPD). This classification would streamline the application of treatment recommendations outlined by the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD). METHODSPatients with obstructive lung function were classified as having COPD, asthma, or ACO based on GINA/GOLD guidelines. We hypothesised that ACO-like asthma (ACO-A) would present with positive skin prick tests (SPTs) or early onset of symptoms without a history of tuberculosis (TB), while those with ACO-like COPD (ACO-B) would exhibit negative SPTs and late onset of symptoms and/or a history of TB. RESULTSAmong 235 patients, the prevalence of asthma, ACO-A, ACO-B, and COPD was respectively 21%, 22%, 17%, and 40%. Allergic history, rhinitis, and childhood asthma were associated with ACO-A, while high cumulative smoking was correlated with ACO-B. Socio-economic and demographic parameters, medical history, clinical features, smoking habits, lung function, and para-clinical investigations significantly differed between "all asthma" (i.e., individuals with asthma combined with ACO-A) and "all COPD" (i.e., individuals with COPD combined with ACO-B). CONCLUSIONBased on SPTs, history of TB, and onset age, ACO patients may be defined as people with asthma or COPD. .