Prevalence of co-morbidities in severe asthma, COPD and overlap syndrome

Rationale: COPD and asthma are associated with co-morbid conditions with prevalences of around 15-40% (Pleassants et al, COPD 2014). However, figures in severe asthma and COPD are unknown. Aim: to investigate the prevalence of co-morbid conditions in patients with severe asthma, COPD and overlap syndrome. Methods: 929 adults with severe asthma, 519 with severe COPD and 703 with overlap syndrome (OS) were selected based on dispensing records from 65 Dutch community pharmacies. All had a prescription for at least high dose inhaled or oral corticosteroids (>1000 µg/day fluticasone eq) with long-acting beta-2-agonists. A diagnosis of asthma, COPD or OS was based on questionnaires about doctor9s diagnosis, (upper) respiratory symptoms, smoking history, and atopy. Co-morbidities were estimated on the basis of prescriptions (cardiovascular disease, diabetes, anxiety/depression, and gastro-esophageal reflux (GERD)), and BMI (obesity). Results: 89.4% of COPD patients had ≥1 prescriptions for co-morbidities vs 84.9% of OS and 75.1% of asthma patients (Table). Prescriptions for cardiovascular disease were most prevalent, followed by GERD, anxiety/depression, obesity and diabetes. All co-morbidities were more prevalent in COPD and OS than in asthma except for obesity. Conclusion: Co-morbidities are extremely prevalent in severe asthma, COPD and overlap syndrome with higher figures in COPD and overlap-syndrome.