title: Multidimensional analyses of long-term clinical courses of asthma and chronic obstructive pulmonary disease.
abstract: Asthma and chronic obstructive pulmonary disease (COPD) are chronic respiratory disorders involving obstructive airway defects. There have been many discussions on their similarities and differences. Although airflow limitation expressed as forced expiratory volume in one second (FEV(1)) has been considered to be the main diagnostic assessment in both diseases, it does not reflect the functional impairment imparted to the patients by these diseases. Therefore, multidimensional approaches using multiple measurements in assessing disease control or severity have been recommended, and multiple endpoints in addition to FEV(1) have been set recently in clinical trials so as not to miss the overall effects. In particular, as improving symptoms and health status as well as pulmonary function are important goals in the management of asthma and COPD, some patient-reported measurements such as health-related quality of life or dyspnea should be included. Nonetheless, there have been few reviews on the long-term clinical course comparing asthma and COPD as predicted by measurements other than airflow limitation. Here, we therefore analyzed and compared longitudinal changes in both physiological measurements and patient-reported measurements in asthma and COPD. Although both diseases showed similar long-term progressive airflow limitation similarly despite guideline-based therapies, disease progression was different in asthma and COPD. In asthma, patient-reported assessments of health status, disability and psychological status remained clinically stable over time, in contrast to the significant deterioration of these parameters in COPD. Thus, because a single measurement of airflow limitation is insufficient to monitor these diseases, multidimensional analyses are important not only for disease control but also for understanding disease progression in asthma and COPD.
authors.affiliation: Department of Respiratory Care and Sleep Control Medicine,. Electronic address: ogato@kuhp.kyoto-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.affiliation: Department of Respiratory Medicine, Hikone Municipal Hospital, Shiga.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tsukino
authors.affiliation: Department of Respiratory Medicine, Tenri Hospital, Nara.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hajiro
authors.affiliation: Department of Respiratory Medicine, Nishi-Kobe Medical Center, Hyogo.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikeda
authors.affiliation: General Internal Medicine, National Hospital Organization Kyoto Medical Center, Kyoto.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koyama
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.affiliation: Department of Respiratory Care and Sleep Control Medicine.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.affiliation: Department of Respiratory Medicine, Murakami Memorial Hospital, Asahi University, Gifu, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nishimura
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005541:Forced Expiratory Volume; D006801:Humans; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D011788:Quality of Life; D013997:Time Factors