Pulmonary Function and Bronchial Hyper-Responsiveness Profile of Indonesian Patients with Asthma – Chronic Obstructive Pulmonary Disease Overlap Syndrome

Abstract

Asthma – chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is characterized by a persistent airway obstruction that has several features of asthma and several features of COPD. ACOS was reported to have lower pulmonary function values compared to patients who had only asthma or COPD. Bronchial hyper-responsiveness profile in ACOS has also not been clearly determined. The current study aimed to determine the pulmonary function and bronchial hyper-responsiveness profile of ACOS. This study was a cross sectional study conducted at Asthma-COPD Outpatient Clinic of national referral hospital for respiratory diseases, the Persahabatan Hospital, Jakarta, Indonesia. ACOS diagnosis was made using the modified 2017 Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Patients are diagnosed with ACOS if they have at least three clinical features that support asthma and COPD. The study involved 60 subjects. After bronchodilator (BD) test, the mean or median forced vital capacity (FVC)% predicted, forced expiratory volume within 1 second (FEV1)% predicted, FEV1/FVC ratio, FEV1 and the percentage of FEV1 were increased of 853%, 76.4%, 67.8%, 158.3 mL, and 101% respectively. Positive methacholine challenge test was found in 97.1% of ACOS patients. ACOS patients had mean post-BD FEV1/FVC of 67.7%, median percentage of FEV1 increase of 10.1% and most of them had positive methacholine challenge test.