Source: International Congress 2014 – Management of asthma and other respiratory diseases in primary care
Disease area: Airway diseases

Abstract

INTRODUCTIONThe new Spanish COPD guideline, GesEPOC, classifies patients into differents phenotypes. The mixed COPD-asthma phenotype (MCAP) is the originality. It needs very strong criteria for its classification.OBJECTIVES1. To asses how many MCAP patients meet criteria2. Which is the most frequent criteriaMATERIAL AND METHODSFrom 401 COPD patients from 6 differents Primary Care (PC) centres in Barcelona we find 36 MCAP patients. We analysed how many meet criteria (2 major criteria or 1 major and 2 minor criteria).Major criteria were:1.To have a bronchodilator test(BT) of 400mL and more than 15% 2. Asthma antecedent. 3. Sputum eosinophilia. Minor criteria were:1.To have atopia 2. To have 2 BT of 220mL and more than 12%. 3.High blood level of IgE. Descriptive and bivariant analysis was made with Chi-square and t-Student tests.RESULTS36 patients out of 401 enrolled the study. Mean age 64,3 year old (SD 8,5). 83,3% were men. 27,8%were current smokers. 19,4% had BT more than 400mL and more than 15%. None of them had sputum eosinophilia. 86,1% had anterior antecedents of asthma. 13,9% were tested for IgE. 19,4% had atopia. 38,9% had 2 or more positive BT. Only 19,4% met criteria (13,8% 2 major criteria and 5,5% with1major+2minor criteria) which may correspond to 7 patients. 91% of the patients are mild/moderate disease. If we classify theses patients with GOLD guideline there are 38,9% A, 13,9% B, 16,7% C and 30,6% D.CONCLUSIONThere are very few MCAP in general. For this phenotype classification it is required very strict criteria and some of them are not usual in primary care (as sputum eosinophilia). The most frequent criteria is to have antecedent of asthma.

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Citations should be made in the following way:
S. Alvarez, X. Flor, L. Lamarca, I. Grau, A. de Pedro, V. Feijoo (Barcelona, Spain). Do we classify by feeling mixed COPD-asthma phenotype patients with GesEPOC?. Eur Respir J 2014; 44: Suppl. 58, 3026

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