Journal article
Clinical Phenotypes of Atopy and Asthma in COPD: A Meta-analysis of SPIROMICS and COPDGene
Chest, Vol.158(6), pp.2333-2345
12/2020
DOI: 10.1016/j.chest.2020.04.069
PMCID: PMC7768932
PMID: 32450244
Abstract
Little is known about the concordance of atopy with asthma COPD overlap. Among individuals with COPD, a better understanding of the phenotypes characterized by asthma overlap and atopy is needed to better target therapies.
What is the overlap between atopy and asthma status among individuals with COPD, and how are categories defined by the presence of atopy and asthma status associated with clinical and radiologic phenotypes and outcomes in the Genetic Epidemiology of COPD Study (COPDGene) and Subpopulation and Intermediate Outcome Measures in COPD Study (SPIROMICS)?
Four hundred three individuals with COPD from SPIROMICS and 696 individuals from COPDGene with data about specific IgEs to 10 common allergens and mixes (simultaneous assessment of combination of allergens in similar category) were included. Comparison groups were defined by atopic and asthma status (neither, atopy alone, atopic asthma, nonatopic asthma, with atopy defined as any positive specific IgE (≥0.35 KU/L) to any of the 10 allergens or mixes and asthma defined as self-report of doctor-diagnosed current asthma). Multivariable regression analyses (linear, logistic, and zero inflated negative binomial where appropriate) adjusted for age, sex, race, lung function, smoking status, pack-years smoked, and use of inhaled corticosteroids were used to determine characteristics of groups and relationship with outcomes (exacerbations, clinical outcomes, CT metrics) separately in COPDGene and SPIROMICS, and then adjusted results were combined using meta-analysis.
The prevalence of atopy was 35% and 36% in COPD subjects from SPIROMICS and COPDGene, respectively, and less than 50% overlap was seen between atopic status with asthma in both cohorts. In meta-analysis, individuals with nonatopic asthma had the most impaired symptom scores (effect size for St. George's Respiratory Questionnaire total score, 4.2; 95% CI, 0.4-7.9; effect size for COPD Assessment Test score, 2.8; 95% CI, 0.089-5.4), highest risk for exacerbations (incidence rate ratio, 1.41; 95% CI, 1.05-1.88) compared with the group without atopy or asthma. Those with atopy and atopic asthma were not at increased risk for adverse outcomes.
Asthma and atopy had incomplete overlap among former and current smokers with COPD in COPDGene and SPIROMICS. Nonatopic asthma was associated with adverse outcomes and exacerbation risk in COPD, whereas groups having atopy alone and atopic asthma had less risk.
Details
- Title: Subtitle
- Clinical Phenotypes of Atopy and Asthma in COPD: A Meta-analysis of SPIROMICS and COPDGene
- Creators
- Nirupama Putcha - Johns Hopkins MedicineAshraf Fawzy - Johns Hopkins MedicineElizabeth C Matsui - The University of Texas at AustinMark C Liu - Johns Hopkins MedicineRuss P Bowler - Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, COPrescott G Woodruff - University of California SystemWanda K O'Neal - University of North Carolina Marsico Lung Institute, Chapel Hill, NC.Alejandro P Comellas - University of IowaMeiLan K Han - University of Michigan–Ann ArborMark T Dransfield - University of Alabama at BirminghamJ Michael Wells - University of Alabama at BirminghamNjira Lugogo - University of Michigan–Ann ArborLi Gao - Johns Hopkins UniversityC Conover Talbot Jr - The Johns Hopkins School of Medicine Institute for Basic Biomedical Sciences, Baltimore, MDEric A Hoffman - University of IowaChristopher B Cooper - University of California SystemLaura M Paulin - Dartmouth–Hitchcock Medical CenterRichard E Kanner - University of UtahGerard Criner - Temple UniversityVictor E Ortega - Wake Forest UniversityR Graham Barr - Columbia University Irving Medical CenterJerry A Krishnan - University of Illinois at ChicagoFernando J Martinez - Cornell UniversityM Bradley Drummond - Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NCRobert A Wise - Johns Hopkins MedicineGregory B Diette - Johns Hopkins MedicineCraig P Hersh - Brigham and Women's HospitalNadia N Hansel - Johns Hopkins Medicine
- Resource Type
- Journal article
- Publication Details
- Chest, Vol.158(6), pp.2333-2345
- DOI
- 10.1016/j.chest.2020.04.069
- PMID
- 32450244
- PMCID
- PMC7768932
- ISSN
- 0012-3692
- eISSN
- 1931-3543
- Grant note
- HHSN268200900017C / NHLBI NIH HHS P30 ES005605 / NIEHS NIH HHS HHSN268200900019C / NHLBI NIH HHS HHSN268200900020C / NHLBI NIH HHS U24 HL141762 / NHLBI NIH HHS U01 HL089897 / NHLBI NIH HHS U01 HL137880 / NHLBI NIH HHS R01 HL125583 / NHLBI NIH HHS HHSN268200900015C / NHLBI NIH HHS HHSN268200900013C / NHLBI NIH HHS R01 HL148215 / NHLBI NIH HHS K24 HL137013 / NHLBI NIH HHS R01 HL130512 / NHLBI NIH HHS P50 MD010431 / NIMHD NIH HHS HHSN268200900016C / NHLBI NIH HHS U01 HL089856 / NHLBI NIH HHS HHSN268200900018C / NHLBI NIH HHS HHSN268200900014C / NHLBI NIH HHS R01 ES022607 / NIEHS NIH HHS K24 AI114769 / NIAID NIH HHS K23 HL123594 / NHLBI NIH HHS
- Language
- English
- Date published
- 12/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984318796902771
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