Evaluation of the Characteristics of Asthma in Severe and Extremely Severe COPD

Figures & data

Table 1 Clinical Characteristics and PFT Data

Parameter	COPD (N=178)
Mean age (years)	65.62±9.28
Sex (M:F, n)	142:36
Height (cm)	164.77±7.43
Weight (kg)	58.25±10.73
Body surface area (m^2)	1.63±0.15
BMI in kg/m^2	21.41±3.48 (range: 13.84–34.67)
BMI (25–32 kg/m^2)	23/178 (12.92%)
BMI (>32 kg/m^2)	4/178 (2.25%)
FVC (% predicted)	60.96±15.83
FEV1 (% predicted)	35.86±9.53
FEV1/FVC	47.65±12.08
PEF (% predicted)	32.18±12.22
MEF (% predicted)	16.98±13.94
MEF25 (% predicted)	15.85±19.60
MEF50 (% predicted)	14.50±13.71
MEF75 (% predicted)	16.31±9.55
MVV (% predicted)	37.16±13.25
VC (% predicted)	59.34±15.26
TLC (% predicted)	104.98±21.77
RV (% predicted)	181.02±51.61
RV/TLC (% predicted)	67.2±10.21
DLCO (% predicted)	42.72±13.36
FeNO (ppb)	22.05±10.75

Notes: Measured pulmonary function values are presented as a percentage of predictive. Data are shown as mean±SD unless indicated otherwise.

Abbreviations: M, male; F, female; BMI, body mass index; FEV₁, the forced expiratory volume in 1 s; FVC, forced vital capacity; PEF, peak expiratory flow; MEF, maximal mid-expiratory flow; MEF25, forced expiratory flow after 25% of FVC; MEF50, forced expiratory flow after 50% of FVC; MEF75, forced expiratory flow after 75% of FVC; MVV, maximal voluntary ventilation; VC, vital capacity; RV, residual volume; TLC, total lung capacity; DLCO, diffusion capacity of the lung for carbon monoxide; FeNO, fractional exhaled nitric oxide; ppb, parts per billion; COPD, chronic obstructive pulmonary disease; PFT, pulmonary function test.

Table 2 Asthma Characteristics in Patients with Severe and Extremely Severe COPD

Parameter
History of asthma	43/178 (24.15%)
History of atopy and allergy Total serum IgE (IU/mL)	21/178 (11.80%) Median 128.85 (1.7–817.7)
IgE ≥ 30 (IU/mL)	46/58 (79.31%)
IgE ≥ 100 (IU/mL)	32/58 (55.17%)
Blood eosinophil absolute (cells/μl)	232.05±217.39 (0–1000)
Blood eosinophils ≥ 150 cells/μl	68/122 (55.74%)
Blood eosinophils ≥ 300 cells/μl	27/122 (22.13%)
Blood eosinophils ≥ 2%	66/122 (54.10%)
Blood eosinophils ≥ 3%	51/122 (41.80%)
Bronchodilator response (BDR)
≥12% increase in FEV1	85/178 (47.75%)
≥12% + ≥200 mL in FEV1	61/178 (34.27%)
≥12% + ≥400 mL in FEV1	9/178 (5.06%)
FeNO (ppb)	22.05±10.75
FeNO (ppb) ≥ 25	51/155 (32.90%)
FeNO (ppb) ≥ 50	4/155 (2.58%)

Note: Data are shown as mean±SD unless indicated otherwise.

Table 3 Asthma Characteristics in Patients with Asthma–COPD Overlap (ACO) and COPD Alone

Parameter	ACOS (N=43)	COPD Alone (N=135)	p-Value
Mean age (years)	61.63±9.91	66.90±8.73	0.208
Sex (M:F, n)	30:13	112:23	0.061
Height (cm)	164.42±7.73	164.88±7.36	0.723
Weight (kg)	60.27±10.34	57.60±10.81	0.155
Body surface area (m^2)	1.65±0.16	1.62±0.16	0.257
BMI (kg/m^2)	22.22±3.07	21.15±3.57	0.082
FVC (% predicted)	63.09±13.33	60.27±16.53	0.311
FEV1 (% predicted)	36.88±9.62	35.53±9.51	0.420
FEV1/FVC	47.21±10.21	47.79±12.64	0.786
PEF (% predicted)	33.88±12.26	31.64±12.20	0.295
MEF (% predicted)	16.02±7.10	17.29±15.51	0.606
MEF25 (% predicted)	14.21±14.39	16.38±21.01	0.529
MEF50 (% predicted)	13.16±6.66	14.93±15.29	0.464
MEF75 (% predicted)	15.30±7.44	16.63±10.14	0.429
MVV (% predicted)	36.47±11.91	37.38±13.68	0.695
VC (% predicted)	61.91±13.97	58.53±15.62	0.207
TLC (% predicted)	100.39±14.69	106.13±23.13	0.260
RV (% predicted)	172.57±38.61	183.13±54.35	0.382
RV/TLC (% predicted)	63.52±8.27	68.12±10.47	0.053
DLCO (% predicted)	46.58±13.39	41.50±13.30	0.255
Total serum IgE (IU/mL)	151.17±43.45	199.16±30.79	0.442
IgE ≥30 IU/mL	10/13	36/45	0.809
IgE ≥100 IU/mL	6/13	26/45	0.066
Blood eosinophil absolute (cells/μl)	230.37±215.24	232.53±206.91	0.961
Blood eosinophils ≥ 150 (cells/μl)	11/27	55/95	0.114
Blood eosinophils ≥ 300 (cells/μl)	6/27	21/95	0.990
Blood eosinophils (%)	2.69±2.49	3.13±2.78	0.452
Blood eosinophils ≥ 2%	12/27	54/95	0.254
Blood eosinophils ≥ 3%	10/27	41/95	0.569
Bronchodilator response (BDR)
≥12% increase in FEV1	31/43	54/135	<0.001
≥12% + ≥200 mL in FEV1	27/43	34/135	<0.001
≥12% + ≥400 mL in FEV1	6/43	3/135	0.007
FeNO (ppb)	26.13±14.91	20.99±9.16	0.016
FeNO (ppb) ≥ 25	17/32	34/123	0.016
FeNO (ppb) ≥ 50	3/32	1/123	0.028

Notes: Measured pulmonary function values are presented as the percentage of predictive. Data are shown as mean±SD unless indicated otherwise.

Abbreviations: M, male; F, female; BMI, body mass index; FEV₁, the forced expiratory volume in 1 s; FVC, forced vital capacity; PEF, peak expiratory flow; MEF, maximal mid-expiratory flow; MEF25, forced expiratory flow after 25% of FVC; MEF50, forced expiratory flow after 50% of FVC; MEF75, forced expiratory flow after 75% of FVC; MVV, maximal voluntary ventilation; VC, vital capacity; RV, residual volume; TLC, total lung capacity; DLCO, diffusion capacity of the lung for carbon monoxide; FeNO, fractional exhaled nitric oxide; ppb, parts per billion; COPD, chronic obstructive pulmonary disease; and ACOS, asthma–COPD overlap syndrome.

Table 4 Asthma Characteristics in Patients with Severe and Extremely Severe COPD

Parameter	30%≤FEV1≤50% (126)	FEV1<30% (52)	p-Value
History of asthma	33/126	10/52	0.324
Total serum IgE (IU/mL)	Median 103.8 (<1.7–817.7)	Median 160.9 (8.21–758.9)	0.299
IgE ≥ 30 IU/mL	33/43	13/15	0.490
IgE ≥ 100 IU/mL	22/43	10/15	0.374
Blood eosinophil absolute (cells/ul)	240.78±215.39	207.50±224.54	0.964
Blood eosinophils ≥ 150 cells/μl	54/90	14/32	0.112
Blood eosinophils ≥ 300 cells/μl	23/90	4/32	0.145
Percent	3.16±2.69	2.68±2.65	0.452
Blood eosinophils ≥ 2%	50/90	16/32	0.588
Blood eosinophils ≥ 3%	42/90	9/32	0.068
Bronchodilator response (BDR)
≥12% increase in FEV1	62/126	23/52	0.546
≥12% + ≥200 mL in FEV1	47/126	14/52	0.185
≥12% + ≥400 mL in FEV1	8/126	1/52	0.287
FeNO (ppb)
FeNO (ppb) ≥ 25	39/108	12/47	0.237
FeNO (ppb) ≥ 50	3/108	1/47	1.000

Note: Data are shown as mean±SD unless indicated otherwise.

Abbreviations: FeNO, fractional exhaled nitric oxide; and ppb, parts per billion.

Figure 1 Correlation of FeNO values with blood eosinophil counts and blood eosinophil percentage in patients with severe and extremely severe COPD.

Notes: The correlations between FeNO values and blood eosinophil counts were determined by calculating Spearman’s rank correlation coefficients.
Abbreviation: FeNO, fractional exhaled nitric oxide.

Figure 2 FeNO values and FEV₁ during follow-up.

Abbreviation: FeNO, fractional exhaled NO.