What pulmonologists think about the asthma-COPD overlap syndrome

Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods:...

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Published in:International Journal of Chronic Obstructive Pulmonary Disease 2015, Vol.10, p.1321
Main Authors: Miravitlles, Marc, Alcazar, Bernardino, Alvarez, Francisco Javier, Bazus, Teresa, Calle, Myriam, Casanova, Ciro, Cisneros, Carolina, de-Torres, Juan P, Entrenas, Luis M, Esteban, Cristobal, Garcia-Sidro, Patricia, Cosio, Borja G, Huerta, Arturo, Iriberri, Milagros, Izquierdo, Jose Luis, Lopez-Vina, Antolrn, Lopez-Campos, Jose Luis, MartrnezMoragon, Eva, de Llano, Luis Perez, Perpina, Miguel, Ros, Jose Antonio, Serrano, Jose, Soler-Cataluna, Juan Jose, Torrego, Alfons, Urrutia, Isabel, Plaza, Vicente
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Language:English
Subjects:
Asthma
Care and treatment
Chronic obstructive lung disease
Evaluation
Practice guidelines (Medicine)
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container_title International Journal of Chronic Obstructive Pulmonary Disease
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creator Miravitlles, Marc
Alcazar, Bernardino
Alvarez, Francisco Javier
Bazus, Teresa
Calle, Myriam
Casanova, Ciro
Cisneros, Carolina
de-Torres, Juan P
Entrenas, Luis M
Esteban, Cristobal
Garcia-Sidro, Patricia
Cosio, Borja G
Huerta, Arturo
Iriberri, Milagros
Izquierdo, Jose Luis
Lopez-Vina, Antolrn
Lopez-Campos, Jose Luis
MartrnezMoragon, Eva
de Llano, Luis Perez
Perpina, Miguel
Ros, Jose Antonio
Serrano, Jose
Soler-Cataluna, Juan Jose
Torrego, Alfons
Urrutia, Isabel
Plaza, Vicente
description Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity
doi_str_mv 10.2147/COPD.S88667
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There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity &lt;0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting [beta]2-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting [beta]2-agonist/inhaled corticosteroids. 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There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity &lt;0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting [beta]2-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting [beta]2-agonist/inhaled corticosteroids. 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this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity &lt;0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting [beta]2-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting [beta]2-agonist/inhaled corticosteroids. Keywords: asthma, COPD, ACOS, survey, guidelines</abstract><pub>Dove Medical Press Limited</pub><doi>10.2147/COPD.S88667</doi></addata></record>
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source Publicly Available Content Database; Taylor & Francis Open Access Journals; PubMed Central
subjects Asthma
Care and treatment
Chronic obstructive lung disease
Evaluation
Practice guidelines (Medicine)
title What pulmonologists think about the asthma-COPD overlap syndrome
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