COPD, Asthma, and Overlap: 6 New Studies

In the first study of its kind, published July 23 in EClinicalMedicine, researchers compared prescribing patterns in a large cohort of unselected COPD patients with the 2019 GOLD recommendations. The study found there was overtreatment with escalation, de-escalation, or switching during follow-up in ~50% of both established patients and those starting therapy. The researchers noted that many patients change effective GOLD groups and therapy over time, that prescribing is not in accordance with guideline recommendations, and that many patients still appear to be overtreated.

Researchers identified 141 regions in genetic material (41 of them novel) that explain the genetic risk that underlies asthma, hay fever, and eczema. Most loci in the genome-wide association study published July 30 in Human Molecular Genetics were associated with the combined phenotype. However, up to 20 loci had a significantly larger effect on hay fever/eczema vs asthma; 26 loci had larger effects on asthma vs hay fever/eczema. The risk of asthma, hay fever, or eczema was impacted by genes, environment, and lifestyle factors.

ACO was present in 1 in 5 patients with a diagnosis of COPD, asthma, or both asthma and COPD in primary care settings, according to a study published June 4 in Annals of the American Thoracic Society. ACO prevalence was highest among patients with both asthma and COPD (32%) vs COPD-only (20%) or asthma-only (14%). The most common comorbidity seen in ACO patients was diabetes (53%) followed by cardiovascular disease (36%); hypertension (30%); eczema (23%); and rhinitis (21%). Clinical characteristics of ACO varied across the populations.

An analysis published July 18 in Preventing Chronic Disease found that the prevalence of age-adjusted COPD was higher in US adults with arthritis (13.7%) vs without (3.8%), especially among those aged 18 to 44 years (11.5% vs 2%, respectively) and never smokers (7.6% vs 1.7%, respectively). Arthritis status was significantly associated with COPD status after controlling for sociodemographic characteristics, risk behaviors, and health-related quality of life measures. Researchers concluded that physicians should assess COPD and arthritis symptoms for earlier detection and recommend patients participate in pulmonary rehabilitation and self-management education programs.

In a study published August 6 in the International Journal of Chronic Obstructive Pulmonary Disease researchers noted the difficulties inherent in making a clear distinction between ACO and COPD with the use of physiological testing techniques. Due to this, researchers tried a novel metabolomic approach with eicosanoids, a class of compounds derived from polyunsaturated fatty acids. Eicosanoids clearly discriminated different biochemical metabolic profiles between ACO and COPD; this new perspective on identifying potential biomarkers of ACO may be helpful for personalized treatment.

Processed meat consumption is linked with an increased risk of COPD in middle-aged women and the presence of other high-risk lifestyle factors adds to the risk. A new analysis, published August 3 in EClinicalMedicine, found a positive association between processed meat intake and the risk of COPD for ≥1 servings/week vs never/almost never. The study also found an association with increased risk of COPD only among ever smokers and women with unhealthy diets. Women with all 3 high-risk lifestyle factors vs none had a multivariable-adjusted hazard ratio for COPD of 6.32.