Heterogeneity within and between physician-diagnosed asthma and/or COPD: NOVELTY cohort

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Heterogeneity within and between physician-diagnosed asthma and/or COPD : NOVELTY cohort

Reddel, Helen K. (författare): Woolcock Inst Med Res, Sydney, NSW, Australia.;Univ Sydney, Sydney, NSW, Australia.

Vestbo, Jorgen (författare): Univ Manchester, Manchester, Lancs, England.;Manchester Univ NHS Fdn Trust, Manchester, Lancs, England.

Agusti, Alvar (författare): Univ Barcelona, Hosp Clin, Resp Inst, CIBERES,IDIBAPS, Barcelona, Spain.

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Anderson, Gary P. (författare): Univ Melbourne, Lung Hlth Res Ctr, Dept Pharmacol & Therapeut, Melbourne, Vic, Australia.

Bansal, Aruna T. (författare): Acclarogen, Cambridge, England.

Beasley, Richard (författare): Med Res Inst New Zealand, Wellington, New Zealand.

Bel, Elisabeth H. (författare): Univ Amsterdam, Locat AMC, Amsterdam UMC, Amsterdam, Netherlands.

Janson, Christer (författare): Uppsala universitet,Lung- allergi- och sömnforskning

Make, Barry (författare): Natl Jewish Hlth, Denver, CO USA.;Univ Colorado, Denver, CO 80202 USA.

Pavord, Ian D. (författare): Univ Oxford, Nuffield Dept Med, Resp Med Unit, Oxford, England.;Univ Oxford, Nuffield Dept Med, Oxford Resp NIHR BRC, Oxford, England.

Price, David (författare): Observat & Pragmat Res Inst, Singapore, Singapore.;Univ Aberdeen, Ctr Acad Primary Care, Div Appl Hlth Sci, Aberdeen, Scotland.

Rapsomaniki, Eleni (författare): AstraZeneca, BioPharmaceut Med, Cambridge, England.

Karlsson, Niklas (författare): AstraZeneca, Patient Ctr Sci, BioPharmaceut Med, Gothenburg, Sweden.

Finch, Donna K. (författare): AstraZeneca, BioPharmaceut R&D, Early Resp & Immunol, Cambridge, England.

Nuevo, Javier (författare): AstraZeneca, Med Dept, BioPharmaceut Med, Madrid, Spain.

De Giorgio-Miller, Alex (författare): AstraZeneca, BioPharmaceut Med, Med & Sci Affairs, Luton, Beds, England.

Alacqua, Marianna (författare): AstraZeneca, Resp & Immunol, BioPharmaceut Med, Med & Payer Evidence Strategy, Cambridge, England.

Hughes, Rod (författare): AstraZeneca, BioPharmaceut Med, External Sci Engagement, Cambridge, England.

Mullerova, Hana (författare): AstraZeneca, Resp & Immunol, BioPharmaceut Med, Med & Payer Evidence Strategy, Cambridge, England.

de Verdier, Maria Gerhardsson (författare): AstraZeneca, BioPharmaceut Med, Resp Med Evidence Strategy, Gothenburg, Sweden.

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Woolcock Inst Med Res, Sydney, NSW, Australia;Univ Sydney, Sydney, NSW, Australia. Univ Manchester, Manchester, Lancs, England.;Manchester Univ NHS Fdn Trust, Manchester, Lancs, England. (creator_code:org_t)

2021-02-25
2021
Engelska.
Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 58:3

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://uu.diva-port... (primary) (Raw object); https://erj.ersjourn...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

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Background Studies of asthma and chronic obstructive pulmonary disease (COPD) typically focus on these diagnoses separately, limiting understanding of disease mechanisms and treatment options. NOVELTY is a global, 3-year, prospective observational study of patients with asthma and/or COPD from real-world clinical practice. We investigated heterogeneity and overlap by diagnosis and severity in this cohort. Methods Patients with physician-assigned asthma, COPD or both (asthma+COPD) were enrolled, and stratified by diagnosis and severity. Baseline characteristics were reported descriptively by physician-assigned diagnosis and/or severity. Factors associated with physician-assessed severity were evaluated using ordinal logistic regression analysis. Results Of 11243 patients, 5940 (52.8%) had physician-assigned asthma, 1396 (12.4%) had asthma+COPD and 3907 (34.8%) had COPD; almost half were from primary care. Symptoms, health-related quality of life and spirometry showed substantial heterogeneity and overlap between asthma, asthma COPD and COPD, with 23%, 62% and 64% of patients, respectively, having a ratio of post-bronchodilator forced expiratory volume in 1 s to forced vital capacity below the lower limit of normal. Symptoms and exacerbations increased with greater physician-assessed severity and were higher in asthma+COPD. however, 24.3% with mild asthma and 20.4% with mild COPD had experienced >= 1 exacerbation in the past 12 months. Medication records suggested both under-treatment and over-treatment relative to severity. Blood eosinophil counts varied little across diagnosis and severity groups, but blood neutrophil counts increased with severity across all diagnoses. Conclusion This analysis demonstrates marked heterogeneity within, and overlap between, physician-assigned diagnosis and severity groups in patients with asthma and/or COPD. Current diagnostic and severity classifications in clinical practice poorly differentiate between clinical phenotypes that may have specific risks and treatment implications.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Lungmedicin och ...

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