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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Matthes, S; Stadler, J; Barton, J; Leuschner, G; Munker, D; Arnold, P; Villena-Hermoza, H; Frankenberger, M; Probst, P; Koch, A; Kneidinger, N; Milger, K; Behr, J; Neurohr, C.
Asthma features in severe COPD: Identifying treatable traits.
Respir Med. 2018; 145:89-94 Doi: 10.1016/j.rmed.2018.10.027
Web of Science PubMed FullText FullText_MUG

Co-Autor*innen der Med Uni Graz: Kneidinger Nikolaus; Milger-Kneidinger Katrin
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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/m², FEV₁ of 0.61 ± 0.2 L (21.1 ± 5.6% pred), pO₂ 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/μl 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.
Find related publications in this database (using NLM MeSH Indexing): Aged - administration & dosage; Allergens - immunology; Antibodies, Monoclonal - therapeutic use; Asthma - drug therapy, etiology, immunology, physiopathology; Cross-Sectional Studies - administration & dosage; Disease Progression - administration & dosage; Forced Expiratory Volume - administration & dosage; Humans - administration & dosage; Immunoglobulin E - immunology; Interleukin-5 - immunology; Middle Aged - administration & dosage; Molecular Targeted Therapy - administration & dosage; Prospective Studies - administration & dosage; Pulmonary Disease, Chronic Obstructive - complications, physiopathology; Severity of Illness Index - administration & dosage
Find related publications in this database (Keywords): COPD; Exacerbations of COPD; Asthma and COPD overlap; Targeted therapy