Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort

Cosío, Borja G.; Soriano, Joan B.; Lόpez-Campos, José Luís; Rubio, Myriam Calle; Soler-Cataluña, Juan José; de-Torres, Juan P.; Marı́n, José Marı́a; Martínez-González, Cristina; Lucas, Pilar de; Mir, Isabel; Peces-Barba, Germán; Feu-Collado, Nuria; Solanes, Ingrid; Alfageme, Inmaculada; Casanova, Ciro; Bonachera, José Calvo; Bautista, Celia Lacárcel; Domenech, Adolfo; Guzmán, Rosirys; Irigaray, Rosa; Zamora, Meritxell López; Ríos, Ángel; Córdova, Rocío; López, Carlos Cabrera; Acosta, Alejandro Sánchez; González, Juan Abreu; Balbín, R. Agüero; Balcells, Eva; Campos, Elena Miguel; Marín, Alicia; Casanova, Antonia Llunel; Moreno, Amàlia; Pérez, Francisca Lourdes Márquez; Miranda, Juan Antonio Riesco; Rodríguez, Julia Tabara; Gómez, Rafael Golpe; Miguel-Díez, Javier de; Río, Francisco García; Lobato, Salvador Díaz; Iturri, Juan Bautista Gáldiz; Royo, Margarita Marín; Damiá, A de Diego

doi:10.1378/chest.15-1055

Cited by 233 publications

(197 citation statements)

References 18 publications

Supporting

Mentioning

154

Contrasting

Unclassified

Order By: Relevance

“…Also, length of hospital stay, intensive care unit stay and duration of mechanical ventilation were longer in COPD patients [24]. CHAIN study, which was performed in Spain on a cohort of COPD patients, ACOS patients were found to have better 1-year survival rates with no significant difference in terms of exacerbation frequency [25].…”

Section: Clinical Propertiesmentioning

confidence: 97%

Asthma COPD overlap syndrome (ACOS)

Kocakaya¹

2016

MMJ

View full text Add to dashboard Cite

Asthma and chronic obstructive pulmonary disease (COPD) are the two most prevalent obstructive diseases of the lung. Although asthma and COPD differ in many ways some properties of each disease co-exist in some patients, particularly in patients with advanced age which recently brought up the term; Asthma-COPD Overlap Syndrome (ACOS). In addition to the fact that clinical trials deliberately exclude the patients in this group, the diagnostic criteria of ACOS are not well established. Both of these factors contribute to paucity of evidence based clinical information about ACOS. In this article my aim is to provide brief information about the history, description, clinical properties and treatment of this disease.

show abstract

Section: Clinical Propertiesmentioning

confidence: 97%

Asthma COPD overlap syndrome (ACOS)

Kocakaya¹

2016

MMJ

View full text Add to dashboard Cite

show abstract

“…the degree of reversibility, i.e., 12% and 200 ml or 15% and 400 ml, or frequency of demonstrating reversibility); the role of biomarkers (blood and/or sputum eosinophil levels, IgE, FeNO and allergy skin tests are all debated without consensus on cut-off levels or their significance if present). [172][173][174] Lastly, there are no randomized controlled pharmacotherapy studies in this patient population. The majority of asthma RCTs exclude smokers and the majority of COPD trials exclude patients with a history of asthma or who demonstrate significant bronchial reversibility.…”

Section: Box 2 Preventing Acute Exacerbation In Stable Copdmentioning

confidence: 99%

CTS position statement: Pharmacotherapy in patients with COPD—An update

Bourbeau

Bhutani

Hernández

et al. 2017

Canadian Journal of Respiratory, Critical Care, and Sleep Medic

View full text Add to dashboard Cite

RATIONALE: Since the last published Canadian Thoracic Society (CTS) COPD guideline in 2007 and the 2008 update -highlights for primary care, many new clinical trials have challenged COPD treatment practices. The current Canadian position statement provides the reader with an update on pharmacotherapy of patients with COPD as reviewed by the CTS. OBJECTIVES: The objectives of this position statement are: 1) to summarize the literature on topics relevant to the pharmacological therapy of patients with stable COPD; and 2) to provide clinical guidance with evidence-based recommendations and expert-informed key messages for the pharmacological therapy for patients with stable COPD. METHODS: The authors systematically reviewed the relevant literature focusing on randomized controlled trials and when available, systematic reviews of randomized controlled trials. The proposed key messages, based on scientific evidence and expert-informed opinion, were agreed upon by a majority consensus. MAIN RESULTS: There is typically a significant delay in seeking medical care by patients with dyspnea, often waiting until symptoms affect the performance of activities of daily living. The diagnosis of COPD requires spirometry to confirm the presence of airflow obstruction in any patient presenting with symptoms and/or risk factors of COPD. An effective management plan for individuals with COPD should include: smoking cessation, vaccination and education. A number of non-pharmacological treatments are available for COPD patients with symptoms to improve outcomes such as self-management with coaching from a health care professional; pulmonary rehabilitation; supplemental oxygen in selected patients; and surgery.Current pharmacotherapy for COPD has been shown to alleviate symptoms and prevent exacerbations and related complications such as hospital admissions. In symptomatic patients with stable COPD not having or having infrequent exacerbation, treatment should be started with inhaled LAMA or LABA monotherapy, and if experiencing persistent or increased dyspnea, exercise intolerance, and/or reduced health status despite use of monotherapy, patients should be considered for treatment "step up" with an inhaled LAMA plus LABA dual therapy. In this situation, the use of a single inhaler would be preferred to simplify the treatment regimen and minimize the cost. In patients with stable COPD experiencing exacerbations despite the use of LAMA or LABA monotherapy, treatment "step up" with inhaled LAMA plus LABA dual therapy should be considered unless a patient has concomitant asthma (Asthma/COPD overlap (ACO)). There has been recent interest in using biomarkers to identify patients who are more likely to respond to ICS. Most of the studies have demonstrated that high blood eosinophils could be valuable to predict an increase response in terms of reduction of exacerbation rate when treated with combination ICS/LABA; there is still uncertainty about the exact cut-off level of blood eosinophils having potential therapeutic value. If a pa...

show abstract

“…The authors stated that the dyspnea, quality of life, exacerbations, comorbidities and mortality are not different from COPD patients [51]. Data on sex predominance of ACOS is conflicting [24,52].…”

Section: Risks Factorsmentioning

confidence: 99%

“…In general subjects with ACOS were more likely to have respiratory symptoms, physical impairment, and to report hospital admissions compared to asthma or COPD alone [24,48,68,69].. On the other hand, ACOS patients have a better one-year prognosis than clinically similar COPD patients with no ACOS criteria [52]. Finally, 15-year mortality rate showed that long-term prognosis of ACOS is similar to COPD, and worse than asthma and healthy controls [70].…”

Section: Assessmentmentioning

confidence: 99%

Ashtma-Chronic obstructive pulmonary disease overlap syndrome (ACOS): current evidence and future research directions

et al. 2017

View full text Add to dashboard Cite

Chronic obstructive pulmonary disease and asthma are the most frequent chronic respiratory diseases that affect the general population. For a long period of time these two conditions were considered to be separate diseases. However, it became evident that some patients share symptoms and clinical findings from both diseases. These patients are considered to represent a distinct phenotype, called asthma-COPD overlap syndrome (ACOS). However, since approximately the one third of the asthmatics smoke the ACOS may primarily define those patients. This is a relatively newly defined clinical syndrome whose underlying mechanisms and most appropriate management remain to be confirmed. In this review, we summarize current knowledge on this syndrome, aiming to update clinicians and help their daily practice.

show abstract

Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort

Cited by 233 publications

References 18 publications

Asthma COPD overlap syndrome (ACOS)

Asthma COPD overlap syndrome (ACOS)

CTS position statement: Pharmacotherapy in patients with COPD—An update

Ashtma-Chronic obstructive pulmonary disease overlap syndrome (ACOS): current evidence and future research directions

Contact Info

Product

Resources

About