Coexisting COPD Increases Mortality in Patients With Corticosteroid-Dependent Asthma: A Nationwide Population-Based Studyopen access
- Authors
- Lee, Hyun; Ryu, Jiin; Chung, Sung Jun; Park, Dong Won; Sohn, Jang Won; Yoon, Ho Joo; Kim, Sang-Heon
- Issue Date
- Sep-2020
- Publisher
- KOREAN ACAD ASTHMA ALLERGY & CLINICAL IMMUNOLOGY
- Keywords
- Mortality; chronic obstructive pulmonary disease; steroids; asthma; treatment; population
- Citation
- ALLERGY ASTHMA & IMMUNOLOGY RESEARCH, v.12, no.5, pp.821 - 831
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- ALLERGY ASTHMA & IMMUNOLOGY RESEARCH
- Volume
- 12
- Number
- 5
- Start Page
- 821
- End Page
- 831
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/8933
- DOI
- 10.4168/aair.2020.12.5.821
- ISSN
- 2092-7355
- Abstract
- Purpose: Chronic corticosteroid (CS) use is a risk factor for long-term mortality in asthmatic patients, and the presence of coexisting chronic obstructive pulmonary disease (COPD) is associated with a severe presentation and poor prognosis. However, the impact of coexisting COPD on long-term mortality in patients with CS-dependent asthma has not been well elucidated. This study aimed to determine the impact of coexisting COPD on long-term mortality in patients with CS-dependent asthma.
Methods: A retrospective cohort of patients with CS-dependent asthma aged 40 years or older was established using records from the Korean National Health Insurance Service database for 2005 to 2015. We classified the subjects into 2 groups according to the presence of COPD and evaluated the hazard ratio (HR) for all-cause mortality in patients with COPD relative to those without COPD.
Results: Of 8,021 patients with CS-dependent asthma, 3,121 (38.9%) had COPD. All-cause mortality was significantly greater in patients with CS-dependent asthma and COPD than in those without COPD (9,955/100,000 person-years vs. 5,585/100,100 person-years, P < 0.001). The adjusted HRs were 1.29 (95% confidence interval [CI], 1.21-1.38), and the associations were especially significant for chronic lower respiratory diseases (subdistribution HR, 2.30; 95% CI, 2.06-2.57) and lung cancer (subdistribution HR, 1.34; 95% CI, 1.02-1.78).
Conclusions: In this population-based retrospective cohort study, the presence of physician-recognized COPD was associated with greater all-cause mortality and greater risk of mortality due to chronic lower respiratory diseases and lung cancer in patients with CS-dependent asthma. Early recognition and appropriate management of COPD can improve treatment outcomes in patients with CS-dependent asthma.
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