"Risk of Worsening Asthma and Chronic Obstructive Pulmonary Disease Overlap is Twice as High in East Asians"

Seoul St. Mary's Hospital Respiratory Medicine Professor Jin-guk Lee Team
Analysis of Prevalence and Exacerbation Risk by Race
No Racial Difference in Prevalence
Exacerbation Risk: Asians 48.4%, Americans 22~28.2%

Professor Jin-guk Lee (left) and Professor Yong-sook Cho, Department of Pulmonology, Seoul St. Mary's Hospital.

[Asia Economy Reporter Lee Gwan-joo] A study has found that the prevalence of patients with overlapping asthma and chronic obstructive pulmonary disease (COPD) is similar regardless of race, but the risk of disease exacerbation is higher in East Asians.

Professor Jin-guk Lee (corresponding author) and Professor Yong-sook Cho (first author) from the Department of Pulmonology at Seoul St. Mary's Hospital, The Catholic University of Korea, announced on the 14th that applying the same diagnostic criteria to this patient group showed similar prevalence regardless of race.

Patients who had asthma when they were young and continue smoking develop chronic obstructive pulmonary disease (COPD). In this case, patients exhibit characteristics of both diseases simultaneously, which is referred to as Asthma-COPD overlap (ACO).

Professor Lee’s team previously reported through past studies that the use of inhaled steroids reduces the risk of exacerbation in ACO patients. However, since there is no unified diagnostic criterion for ACO patients yet, prevalence, characteristics, and prognosis have been reported differently depending on the study.

The research team defined ACO as cases where lung function increased by 15% and 400 ml or more after inhaling a bronchodilator, or where peripheral blood eosinophils were 300/μl or higher, targeting 1,568 Asians, 1,901 non-Hispanic Whites, and 523 African Americans from COPD cohorts (3,992 people) in Korea and the United States.

The prevalence of ACO was confirmed to be 17.4% to 23.8% (African Americans 17.4%, non-Hispanic Whites 21.4%, Asians 23.8%), and after one year of follow-up, exacerbations occurred in 48.4% of Asians, 28.2% of non-Hispanic Whites, and 22% of African Americans.

When comparing the risk of exacerbation between ACO and non-ACO COPD patients within the same race, the risk was significantly higher in Asian and non-Hispanic White ACO patients than in COPD-only patients. Additionally, the use of inhaled steroids was found to significantly reduce the risk of exacerbation in the overall ACO patient group.

Professor Jin-guk Lee said, “Until now, there has been no established diagnostic and treatment criteria for ACO in the academic community, leading to differing opinions among experts, and clinical evidence regarding the role of inhaled steroid treatment has been insufficient. The significance of this study, conducted on large-scale domestic and international cohorts using the same diagnostic criteria, is that the prevalence of ACO is similar regardless of race, and treatment including inhaled steroids can reduce the risk of exacerbation in patients with a high likelihood of ACO.”

The results of this study were recently published in the international academic journal ‘Frontiers in Medicine.’

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