Identification and definition of asthma–COPD overlap: The CanCOLD study

Miriam Barrecheguren; Lancelot Pinto; Seyed Mohammad Yousof Mostafavi-Pour-Manshadi; Wan C. Tan; Pei Z. Li; Shawn D. Aaron; Andrea Benedetti; Kenneth R. Chapman; Brandie Walker; J. Mark Fitzgerald; Paul Hernandez; François Maltais; Darcy D. Marciniuk; Denis E. O'Donnell; Don D. Sin; Jean Bourbeau

doi:10.1111/resp.13780

Identification and definition of asthma–COPD overlap: The CanCOLD study

Miriam Barrecheguren, Lancelot Pinto, Seyed Mohammad Yousof Mostafavi-Pour-Manshadi, Wan C. Tan, Pei Z. Li, Shawn D. Aaron, Andrea Benedetti, Kenneth R. Chapman, Brandie Walker, J. Mark Fitzgerald, Paul Hernandez, François Maltais, Darcy D. Marciniuk, Denis E. O'Donnell, Don D. Sin, Jean Bourbeau

Medicine

Résultat de recherche: Article › examen par les pairs

50 Citations (Scopus)

Résumé

Background and objective: Lack of consensus on diagnosis of ACO limits our understanding of the impact, management and outcomes of ACO. The present observational study aims to describe the prevalence, clinical characteristics and course of individuals with ACO based on various definitions used in clinical practice. Methods: We included individuals with COPD from the prospective, multisite CanCOLD study and defined subjects with ACO using seven definitions commonly used in the literature. Results: Data including questionnaires, lung function and CT scans were analysed from 522 individuals with COPD who were randomly recruited from the population. Among them, 264 fulfilled at least one of the seven definitions of ACO. Prevalence of ACO varied from 3.8% to 31%. Regardless of the definition, individuals with ACO had worse outcomes (lung function and higher percentage of fast decliners, symptoms and exacerbations, health-related quality of life and comorbidities) than the remaining patients with COPD. Conversely, patients with non-ACO had higher emphysema and bronchiolitis scores. The three definitions that included atopy and/or physician diagnosis of asthma identified subjects who differed significantly from patients with COPD. The two ACO definitions with post-bronchodilator reversibility were concordant with COPD and were the least stable, with less than 50% of the patients from each group maintaining reversibility over visits. Conclusion: Atopy and physician-diagnosed asthma are more distinguishing characteristics to identify ACO. This finding needs to be validated using measures of airway inflammation and other specific biomarkers.

Langue d'origine	English
Pages (de-à)	836-849
Nombre de pages	14
Journal	Respirology
Volume	25
Numéro de publication	8
DOI	https://doi.org/10.1111/resp.13780
Statut de publication	Published - août 1 2020

Note bibliographique

Funding Information:
The CanCOLD study is currently funded by the Canadian Respiratory Research Network (CRRN); industry partners: Astra Zeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd and Novartis. Researchers at RI‐MUHC Montreal and Icapture Centre Vancouver lead the project. Previous funding partners are the CIHR (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326), the Respiratory Health Network of the FRQS and industry partners: Almirall, Merck Nycomed, Pfizer Canada Ltd and Theratechnologies. The funders had no role in the study design, data collection and analysis or preparation of the manuscript. W.C. T reports grants from Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326) with industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, Novartis Pharma Canada Inc., Nycomed Canada Inc., Pfizer Canada Ltd, during the conduct of the study. K.R.C. reports grants from Novartis, Almirall, Boehringer Ingelheim, Forest, GSK, AstraZeneca, Amgen, Roche, CSL Behring, Grifols, Genentech and Kamada, during the conduct of the study; U.H.N. administered personal support from CIHR (GSK Research Chair in Respiratory Health Care Delivery), outside the submitted work. B.W. reports grants from Canadian Institute of Health Research, AstraZeneca Canada Ltd, Boehringer Ingelheim Canada, GlaxoSmithKline Canada and Novartis, during the conduct of the study; grants from Respiratory Health Strategic Clinical Network Alberta, personal fees from AstraZeneca, GlaxoSmithKline and Novartis, outside the submitted work. P H. reports grants from Canadian Institute Health Research, during the conduct of the study; grants and personal fees from AstraZeneca, Boehringer Ingelheim,GlaxoSmithKline, Novartis and Takeda, personal fees from Merck, Grifols, Pfizer and Almirall, grants from CSL Behring, outside the submitted work. D.D.S. reports grants from Merck, personal fees for advisory board work from Sanofi‐Aventis and Regeneron, grants and personal fees from Boehringer Ingelheim, grants and personal fees for lectures and advisory board work from AstraZeneca, personal fees for lectures and advisory board work from Novartis, outside the submitted work, J. Bourbeau reports grants from Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326) with industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, NovartisPharma Canada Inc., Nycomed Canada Inc., Pfizer Canada Ltd, during the conduct of the study.

Funding Information:
The authors thank the men and women who participated in the study and individuals in the . CanCOLD Collaborative Research Group and acknowledge funding by the Canadian Respiratory Research Network (CRRN)

Publisher Copyright:
© 2020 Asian Pacific Society of Respirology

ASJC Scopus Subject Areas

Pulmonary and Respiratory Medicine

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't

Accès au document

10.1111/resp.13780

Autres fichiers et liens

Citer

Barrecheguren, M., Pinto, L., Mostafavi-Pour-Manshadi, S. M. Y., Tan, W. C., Li, P. Z., Aaron, S. D., Benedetti, A., Chapman, K. R., Walker, B., Fitzgerald, J. M., Hernandez, P., Maltais, F., Marciniuk, D. D., O'Donnell, D. E., Sin, D. D., & Bourbeau, J. (2020). Identification and definition of asthma–COPD overlap: The CanCOLD study. Respirology, 25(8), 836-849. https://doi.org/10.1111/resp.13780

Barrecheguren, M, Pinto, L, Mostafavi-Pour-Manshadi, SMY, Tan, WC, Li, PZ, Aaron, SD, Benedetti, A, Chapman, KR, Walker, B, Fitzgerald, JM, Hernandez, P, Maltais, F, Marciniuk, DD, O'Donnell, DE, Sin, DD & Bourbeau, J 2020, 'Identification and definition of asthma–COPD overlap: The CanCOLD study', Respirology, vol. 25, n° 8, pp. 836-849. https://doi.org/10.1111/resp.13780

@article{394c01cadad5405c9b47ac94b734539d,

title = "Identification and definition of asthma–COPD overlap: The CanCOLD study",

abstract = "Background and objective: Lack of consensus on diagnosis of ACO limits our understanding of the impact, management and outcomes of ACO. The present observational study aims to describe the prevalence, clinical characteristics and course of individuals with ACO based on various definitions used in clinical practice. Methods: We included individuals with COPD from the prospective, multisite CanCOLD study and defined subjects with ACO using seven definitions commonly used in the literature. Results: Data including questionnaires, lung function and CT scans were analysed from 522 individuals with COPD who were randomly recruited from the population. Among them, 264 fulfilled at least one of the seven definitions of ACO. Prevalence of ACO varied from 3.8% to 31%. Regardless of the definition, individuals with ACO had worse outcomes (lung function and higher percentage of fast decliners, symptoms and exacerbations, health-related quality of life and comorbidities) than the remaining patients with COPD. Conversely, patients with non-ACO had higher emphysema and bronchiolitis scores. The three definitions that included atopy and/or physician diagnosis of asthma identified subjects who differed significantly from patients with COPD. The two ACO definitions with post-bronchodilator reversibility were concordant with COPD and were the least stable, with less than 50% of the patients from each group maintaining reversibility over visits. Conclusion: Atopy and physician-diagnosed asthma are more distinguishing characteristics to identify ACO. This finding needs to be validated using measures of airway inflammation and other specific biomarkers.",

author = "Miriam Barrecheguren and Lancelot Pinto and Mostafavi-Pour-Manshadi, {Seyed Mohammad Yousof} and Tan, {Wan C.} and Li, {Pei Z.} and Aaron, {Shawn D.} and Andrea Benedetti and Chapman, {Kenneth R.} and Brandie Walker and Fitzgerald, {J. Mark} and Paul Hernandez and Fran{\c c}ois Maltais and Marciniuk, {Darcy D.} and O'Donnell, {Denis E.} and Sin, {Don D.} and Jean Bourbeau",

note = "Funding Information: The CanCOLD study is currently funded by the Canadian Respiratory Research Network (CRRN); industry partners: Astra Zeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd and Novartis. Researchers at RI‐MUHC Montreal and Icapture Centre Vancouver lead the project. Previous funding partners are the CIHR (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326), the Respiratory Health Network of the FRQS and industry partners: Almirall, Merck Nycomed, Pfizer Canada Ltd and Theratechnologies. The funders had no role in the study design, data collection and analysis or preparation of the manuscript. W.C. T reports grants from Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326) with industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, Novartis Pharma Canada Inc., Nycomed Canada Inc., Pfizer Canada Ltd, during the conduct of the study. K.R.C. reports grants from Novartis, Almirall, Boehringer Ingelheim, Forest, GSK, AstraZeneca, Amgen, Roche, CSL Behring, Grifols, Genentech and Kamada, during the conduct of the study; U.H.N. administered personal support from CIHR (GSK Research Chair in Respiratory Health Care Delivery), outside the submitted work. B.W. reports grants from Canadian Institute of Health Research, AstraZeneca Canada Ltd, Boehringer Ingelheim Canada, GlaxoSmithKline Canada and Novartis, during the conduct of the study; grants from Respiratory Health Strategic Clinical Network Alberta, personal fees from AstraZeneca, GlaxoSmithKline and Novartis, outside the submitted work. P H. reports grants from Canadian Institute Health Research, during the conduct of the study; grants and personal fees from AstraZeneca, Boehringer Ingelheim,GlaxoSmithKline, Novartis and Takeda, personal fees from Merck, Grifols, Pfizer and Almirall, grants from CSL Behring, outside the submitted work. D.D.S. reports grants from Merck, personal fees for advisory board work from Sanofi‐Aventis and Regeneron, grants and personal fees from Boehringer Ingelheim, grants and personal fees for lectures and advisory board work from AstraZeneca, personal fees for lectures and advisory board work from Novartis, outside the submitted work, J. Bourbeau reports grants from Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326) with industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, NovartisPharma Canada Inc., Nycomed Canada Inc., Pfizer Canada Ltd, during the conduct of the study. Funding Information: The authors thank the men and women who participated in the study and individuals in the . CanCOLD Collaborative Research Group and acknowledge funding by the Canadian Respiratory Research Network (CRRN) Publisher Copyright: {\textcopyright} 2020 Asian Pacific Society of Respirology",

year = "2020",

month = aug,

day = "1",

doi = "10.1111/resp.13780",

language = "English",

volume = "25",

pages = "836--849",

journal = "Respirology",

issn = "1323-7799",

publisher = "Wiley-Blackwell",

number = "8",

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TY - JOUR

T1 - Identification and definition of asthma–COPD overlap

T2 - The CanCOLD study

AU - Barrecheguren, Miriam

AU - Pinto, Lancelot

AU - Mostafavi-Pour-Manshadi, Seyed Mohammad Yousof

AU - Tan, Wan C.

AU - Li, Pei Z.

AU - Aaron, Shawn D.

AU - Benedetti, Andrea

AU - Chapman, Kenneth R.

AU - Walker, Brandie

AU - Fitzgerald, J. Mark

AU - Hernandez, Paul

AU - Maltais, François

AU - Marciniuk, Darcy D.

AU - O'Donnell, Denis E.

AU - Sin, Don D.

AU - Bourbeau, Jean

N1 - Funding Information: The CanCOLD study is currently funded by the Canadian Respiratory Research Network (CRRN); industry partners: Astra Zeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd and Novartis. Researchers at RI‐MUHC Montreal and Icapture Centre Vancouver lead the project. Previous funding partners are the CIHR (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326), the Respiratory Health Network of the FRQS and industry partners: Almirall, Merck Nycomed, Pfizer Canada Ltd and Theratechnologies. The funders had no role in the study design, data collection and analysis or preparation of the manuscript. W.C. T reports grants from Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326) with industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, Novartis Pharma Canada Inc., Nycomed Canada Inc., Pfizer Canada Ltd, during the conduct of the study. K.R.C. reports grants from Novartis, Almirall, Boehringer Ingelheim, Forest, GSK, AstraZeneca, Amgen, Roche, CSL Behring, Grifols, Genentech and Kamada, during the conduct of the study; U.H.N. administered personal support from CIHR (GSK Research Chair in Respiratory Health Care Delivery), outside the submitted work. B.W. reports grants from Canadian Institute of Health Research, AstraZeneca Canada Ltd, Boehringer Ingelheim Canada, GlaxoSmithKline Canada and Novartis, during the conduct of the study; grants from Respiratory Health Strategic Clinical Network Alberta, personal fees from AstraZeneca, GlaxoSmithKline and Novartis, outside the submitted work. P H. reports grants from Canadian Institute Health Research, during the conduct of the study; grants and personal fees from AstraZeneca, Boehringer Ingelheim,GlaxoSmithKline, Novartis and Takeda, personal fees from Merck, Grifols, Pfizer and Almirall, grants from CSL Behring, outside the submitted work. D.D.S. reports grants from Merck, personal fees for advisory board work from Sanofi‐Aventis and Regeneron, grants and personal fees from Boehringer Ingelheim, grants and personal fees for lectures and advisory board work from AstraZeneca, personal fees for lectures and advisory board work from Novartis, outside the submitted work, J. Bourbeau reports grants from Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants‐93326) with industry partners AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, NovartisPharma Canada Inc., Nycomed Canada Inc., Pfizer Canada Ltd, during the conduct of the study. Funding Information: The authors thank the men and women who participated in the study and individuals in the . CanCOLD Collaborative Research Group and acknowledge funding by the Canadian Respiratory Research Network (CRRN) Publisher Copyright: © 2020 Asian Pacific Society of Respirology

PY - 2020/8/1

Y1 - 2020/8/1

N2 - Background and objective: Lack of consensus on diagnosis of ACO limits our understanding of the impact, management and outcomes of ACO. The present observational study aims to describe the prevalence, clinical characteristics and course of individuals with ACO based on various definitions used in clinical practice. Methods: We included individuals with COPD from the prospective, multisite CanCOLD study and defined subjects with ACO using seven definitions commonly used in the literature. Results: Data including questionnaires, lung function and CT scans were analysed from 522 individuals with COPD who were randomly recruited from the population. Among them, 264 fulfilled at least one of the seven definitions of ACO. Prevalence of ACO varied from 3.8% to 31%. Regardless of the definition, individuals with ACO had worse outcomes (lung function and higher percentage of fast decliners, symptoms and exacerbations, health-related quality of life and comorbidities) than the remaining patients with COPD. Conversely, patients with non-ACO had higher emphysema and bronchiolitis scores. The three definitions that included atopy and/or physician diagnosis of asthma identified subjects who differed significantly from patients with COPD. The two ACO definitions with post-bronchodilator reversibility were concordant with COPD and were the least stable, with less than 50% of the patients from each group maintaining reversibility over visits. Conclusion: Atopy and physician-diagnosed asthma are more distinguishing characteristics to identify ACO. This finding needs to be validated using measures of airway inflammation and other specific biomarkers.

AB - Background and objective: Lack of consensus on diagnosis of ACO limits our understanding of the impact, management and outcomes of ACO. The present observational study aims to describe the prevalence, clinical characteristics and course of individuals with ACO based on various definitions used in clinical practice. Methods: We included individuals with COPD from the prospective, multisite CanCOLD study and defined subjects with ACO using seven definitions commonly used in the literature. Results: Data including questionnaires, lung function and CT scans were analysed from 522 individuals with COPD who were randomly recruited from the population. Among them, 264 fulfilled at least one of the seven definitions of ACO. Prevalence of ACO varied from 3.8% to 31%. Regardless of the definition, individuals with ACO had worse outcomes (lung function and higher percentage of fast decliners, symptoms and exacerbations, health-related quality of life and comorbidities) than the remaining patients with COPD. Conversely, patients with non-ACO had higher emphysema and bronchiolitis scores. The three definitions that included atopy and/or physician diagnosis of asthma identified subjects who differed significantly from patients with COPD. The two ACO definitions with post-bronchodilator reversibility were concordant with COPD and were the least stable, with less than 50% of the patients from each group maintaining reversibility over visits. Conclusion: Atopy and physician-diagnosed asthma are more distinguishing characteristics to identify ACO. This finding needs to be validated using measures of airway inflammation and other specific biomarkers.

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Identification and definition of asthma–COPD overlap: The CanCOLD study

Résumé

Note bibliographique

ASJC Scopus Subject Areas

PubMed: MeSH publication types

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