TY - JOUR T1 - Lung function (LF) decline and hospitalization in subjects with the asthma-COPD overlap syndrome JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - 4871 AU - Roberto de Marco AU - Alessandro Marcon AU - Josep Antó AU - Isa Cerveri AU - Thorarinn Gislason AU - Joachim Heinrich AU - Christer Janson AU - Deborah Jarvis AU - Nino Kuenzli AU - Bénédicte Leynaert AU - Cecilie Svanes AU - Matthias Wjst AU - Peter Burney Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/4871.abstract N2 - Whether the asthma-COPD overlap syndrome is the result of asthma that has progressed to fixed airflow obstruction, the outcome of COPD in subjects with airway hyperresponsiveness, or a specific phenotype is still an open question.We investigated LF decline and hospitalization in a 9-year prospective study of subjects with current asthma, COPD, or both.Participants in both ECRHS I (when 20-44 year-old) and II 9 years apart were classified at baseline as having: current asthma only (n=964: either ever asthma or PD20<1mg methacholine, plus current symptoms), COPD only (n=231: FEV1/FVC<LLN at both occasions), both (overlap syndrome: n=223) and neither of the three (n=5573). The outcomes considered were change in FEV1 (ΔFEV1) and FVC (ΔFVC) during follow-up and hospitalization for respiratory problems. Estimates were adjusted for sex, age and height.At baseline, subjects with the overlap syndrome had the lowest FEV1 and FVC. They had similar familiarity for asthma and childhood respiratory infections compared to subjects with asthma only. Subjects with COPD had the greatest exposure to smoking. During the follow-up, subjects with COPD had a greater ΔFEV1 (-37ml/y) and ΔFVC (-35mL/y) with respect to subjects with asthma (ΔFEV1: -28; ΔFVC: -23 mL/y) or the overlap syndrome (ΔFEV1: -28; ΔFVC: -24mL/y) (p<0.001). Subjects with the overlap syndrome had the greatest risk of hospitalization for respiratory problems (20% vs. asthma: 14%, and COPD: 8%) (p<0.001).In young adults, the overlap syndrome may identify a subgroup of severe asthmatics with a greater risk of hospitalisation but a lower LF decline than subjects with COPD. ER -