The Asthma COPD Overlap Syndrome (ACOS)

Overview

Journal Curr Allergy Asthma Rep

Specialties Allergy & Immunology
Pulmonary Medicine

Date 2015 Feb 26

PMID 25712010

Citations 26

Authors

Stephen Bujarski

Amit D Parulekar

Amir Sharafkhaneh

Nicola A Hanania

Affiliations

Soon will be listed here.

Abstract

Asthma and chronic obstructive pulmonary disease (COPD) have traditionally been viewed as distinct clinical entities. Recently, however, much attention has been focused on patients with overlapping features of both asthma and COPD: those with asthma COPD overlap syndrome (ACOS). Although no universal definition criteria exist, recent publications attempted to define patients with ACOS based on differences in clinical features, radiographic findings, and diagnostic tests. Patients with ACOS make up a large percentage of those with obstructive lung disease and have a higher overall health-care burden. Identifying patients with ACOS has significant therapeutic implications particularly with the need for early use of inhaled corticosteroids and the avoidance of use of long-acting bronchodilators alone in such patients. However, unlike asthma and COPD, no evidence-based guidelines for the management of ACOS currently exist. Future research is needed to improve our understanding of ACOS and to achieve the best management strategies.

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References

Miravitlles M, Soler-Cataluna J, Calle M, Molina J, Almagro P, Quintano J . A new approach to grading and treating COPD based on clinical phenotypes: summary of the Spanish COPD guidelines (GesEPOC). Prim Care Respir J. 2013; 22(1):117-21. PMC: 6442753. DOI: 10.4104/pcrj.2013.00016. View

Peters S, Bleecker E, Kunselman S, Icitovic N, Moore W, Pascual R . Predictors of response to tiotropium versus salmeterol in asthmatic adults. J Allergy Clin Immunol. 2013; 132(5):1068-1074.e1. PMC: 3826080. DOI: 10.1016/j.jaci.2013.08.003. View

Burge P, Calverley P, Jones P, Spencer S, ANDERSON J, Maslen T . Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ. 2000; 320(7245):1297-303. PMC: 27372. DOI: 10.1136/bmj.320.7245.1297. View

Miravitlles M, Calle M, Soler-Cataluna J . Clinical phenotypes of COPD: identification, definition and implications for guidelines. Arch Bronconeumol. 2011; 48(3):86-98. DOI: 10.1016/j.arbres.2011.10.007. View

Hanania N, Calverley P, Dransfield M, Karpel J, Brose M, Zhu H . Pooled subpopulation analyses of the effects of roflumilast on exacerbations and lung function in COPD. Respir Med. 2013; 108(2):366-75. DOI: 10.1016/j.rmed.2013.09.018. View

Leigh R, Pizzichini M, Morris M, Maltais F, Hargreave F, Pizzichini E . Stable COPD: predicting benefit from high-dose inhaled corticosteroid treatment. Eur Respir J. 2006; 27(5):964-71. DOI: 10.1183/09031936.06.00072105. View

Singh S, Amin A, Loke Y . Long-term use of inhaled corticosteroids and the risk of pneumonia in chronic obstructive pulmonary disease: a meta-analysis. Arch Intern Med. 2009; 169(3):219-29. DOI: 10.1001/archinternmed.2008.550. View

Tashkin D, Celli B, Decramer M, Liu D, Burkhart D, Cassino C . Bronchodilator responsiveness in patients with COPD. Eur Respir J. 2008; 31(4):742-50. DOI: 10.1183/09031936.00129607. View

Kitaguchi Y, Fujimoto K, Kubo K, Honda T . Characteristics of COPD phenotypes classified according to the findings of HRCT. Respir Med. 2006; 100(10):1742-52. DOI: 10.1016/j.rmed.2006.02.003. View

10.

Yoshida M, Nakano T, Fukuyama S, Matsumoto T, Eguchi M, Moriwaki A . Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes. Pulm Pharmacol Ther. 2012; 26(2):159-66. DOI: 10.1016/j.pupt.2012.09.007. View

11.

Brightling C, Monteiro W, WARD R, Parker D, Morgan M, Wardlaw A . Sputum eosinophilia and short-term response to prednisolone in chronic obstructive pulmonary disease: a randomised controlled trial. Lancet. 2000; 356(9240):1480-5. DOI: 10.1016/S0140-6736(00)02872-5. View

12.

Contoli M, Baraldo S, Marku B, Casolari P, Marwick J, Turato G . Fixed airflow obstruction due to asthma or chronic obstructive pulmonary disease: 5-year follow-up. J Allergy Clin Immunol. 2010; 125(4):830-7. DOI: 10.1016/j.jaci.2010.01.003. View

13.

Kerstjens H, Overbeek S, Schouten J, Brand P, Postma D . Airways hyperresponsiveness, bronchodilator response, allergy and smoking predict improvement in FEV1 during long-term inhaled corticosteroid treatment. Dutch CNSLD Study Group. Eur Respir J. 1993; 6(6):868-76. View

14.

Silva G, Sherrill D, Guerra S, Barbee R . Asthma as a risk factor for COPD in a longitudinal study. Chest. 2004; 126(1):59-65. DOI: 10.1378/chest.126.1.59. View

15.

de Marco R, Pesce G, Marcon A, Accordini S, Antonicelli L, Bugiani M . The coexistence of asthma and chronic obstructive pulmonary disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population. PLoS One. 2013; 8(5):e62985. PMC: 3651288. DOI: 10.1371/journal.pone.0062985. View

16.

Domingo C . Omalizumab for severe asthma: efficacy beyond the atopic patient?. Drugs. 2014; 74(5):521-33. DOI: 10.1007/s40265-014-0203-y. View

17.

Fingleton J, Weatherall M, Beasley R . Towards individualised treatment in COPD. Thorax. 2011; 66(5):363-4. DOI: 10.1136/thx.2010.155564. View

18.

de Marco R, Accordini S, Cerveri I, Corsico A, Anto J, Kunzli N . Incidence of chronic obstructive pulmonary disease in a cohort of young adults according to the presence of chronic cough and phlegm. Am J Respir Crit Care Med. 2006; 175(1):32-9. DOI: 10.1164/rccm.200603-381OC. View

19.

Magnussen H, Bugnas B, van Noord J, Schmidt P, Gerken F, Kesten S . Improvements with tiotropium in COPD patients with concomitant asthma. Respir Med. 2007; 102(1):50-6. DOI: 10.1016/j.rmed.2007.08.003. View

20.

Travers J, Marsh S, Caldwell B, Williams M, Aldington S, Weatherall M . External validity of randomized controlled trials in COPD. Respir Med. 2006; 101(6):1313-20. DOI: 10.1016/j.rmed.2006.10.011. View