TO DETERMINE THE PREVALENCE OF ACO AMONG COPD PATIENTS, DEFINE THEIR DEMOGRAPHIC, FUNCTIONAL CHARACTERISTICS, AND ASSESS THE NEED INHALED CORTICOSTEROID ( ICS)

Abstract

Background: Asthma-COPD overlap ( ACO) shares features of both asthma and COPD. Materials and Methods: A prospective observational study was conducted with 170 stable COPD patients. Spirometry measurements were used to obtain FEV1 values. Eosinophilic inflammatory markers, including total eosinophil count, serum IgE, sputum eosinophil counts, and FeNO, were measured and analysed. ACO diagnosis was made using the criteria outlined by Sin et al. The study compared the severity of symptoms, frequency of exacerbations, and eosinophilic inflammation markers between the ACO and COPD groups. Results: ACO prevalence was 26.9%. No significant differences in gender, age group, or smoking index and respiratory symptoms between the two groups, with both groups predominantly male and in the age range of 50 to 60 years. Exacerbations and family history of atopy were more common in the ACO group (p = 0.045, p < 0.001, respectively). Sputum eosinophils, total eosinophil count, and bronchodilator reversibility were significantly higher in the ACO group (p = 0.005, p < 0.001, p < 0.001). No differences were found in FeNO or serum IgE levels . Conclusion: ACO should be considered a distinct entity in COPD management due to its higher exacerbation risk and need for more aggressive treatment. A family history of atopy is a key factor in its development, while elevated eosinophilic markers emphasize the role ICS in treatment .