TY - JOUR T1 - Natural history of disease burden for US patients with asthma vs asthma and COPD JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.1397 VL - 56 IS - suppl 64 SP - 1397 AU - Eugene R. Bleecker AU - Kevin Murphy AU - Hitesh N. Gandhi AU - Ileen Gilbert AU - Joseph Zein AU - Joan Reibman AU - Geoffrey Chupp Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/1397.abstract N2 - Background: Some patients with asthma are also labeled with COPD. A real-world cross-sectional analysis of pharmacy claims is a novel approach to identify factors associated with these complex phenotypes.Aim: Examine the morbidity of asthma vs asthma and COPD over the lifespan.Methods: Age-related prevalence and systemic corticosteroid (SCS) and short-acting beta2-agonist (SABA) use were retrospectively analyzed via IQVIA Longitudinal Access and Adjudication Data. 5.6 M US patients with an asthma diagnosis (dx) in 2015–2018 and a 2016 medication claim were included. Exacerbations were defined by SCS use and symptom burden by SABA fills within 1 year of first asthma claim.Results: 4.47 M had an asthma dx (mean[SD] 31[23], median 26 yrs) and 1.15 M had an asthma and COPD dx (52[21], 57 yrs), of which 251,723 were <40 yrs. At all ages, incidence of asthma alone was greater (Fig.). Patterns of age-related exacerbations and symptom burden rose and fell similarly; however, asthma and COPD patients had more exacerbations and symptom burden over the lifespan. For both groups the proportion of patients with ≥2 SCS or ≥3 SABA fills was lowest at age 12-17 and peaked at age 35-49.Conclusion: Some asthmatics are labeled as also having COPD. These patients show greater disease burden than those with asthma alone. The early onset and age-related patterns of morbidity imply factors outside of tobacco contribute to a dual asthma and COPD label.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1397.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -