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  • Title: Responsiveness to inhaled corticosteroid treatment in patients with asthma-chronic obstructive pulmonary disease overlap syndrome.
    Author: Lim HS, Choi SM, Lee J, Park YS, Lee SM, Yim JJ, Yoo CG, Kim YW, Han SK, Lee CH.
    Journal: Ann Allergy Asthma Immunol; 2014 Dec; 113(6):652-7. PubMed ID: 25280465.
    Abstract:
    BACKGROUND: Inhaled corticosteroid (ICS) is recommended in the management of patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS), but its effectiveness has not been clearly proved. OBJECTIVE: To evaluate whether ICS has effects on outcomes of ACOS. METHODS: In this observational 12-year retrospective cohort study involving 125 patients with ACOS from Seoul National University Hospital, the annual rate of decrease in forced expiration volume in 1 second, the incidence rate of severe exacerbation, and overall mortality in an ICS-treated group were compared with those in a non-ICS-treated group. RESULTS: Of 125 patients with ACOS, 90 and 35 were categorized to the ICS and non-ICS treatment groups, respectively. There were no significant differences between the 2 groups in the annual rate of decrease in forced expiration volume in 1 second (9.61 mL/year in ICS treatment group vs 15.68 mL/year in non-ICS treatment group, P = .598). Compared with the non-ICS treatment group, the ICS treatment group did not show a decrease in the risk of severe exacerbation (adjusted incidence rate ratio 1.24, 95% confidence interval 0.44-3.46). Time to death also did not differ between the 2 groups. Even when analyses with propensity score matching were performed, the results were similar. CONCLUSION: In the management of ACOS, the use of ICS was not significantly associated with improvements in the annual rate of decrease in forced expiration volume in 1 second, the incidence of severe exacerbations, and overall mortality compared with the non-ICS treatment group.
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