Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 10 » Issue 1

Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review

Authors Nielsen M, Bårnes CB, Ulrik CS

Received 24 March 2015

Accepted for publication 12 May 2015

Published 27 July 2015 Volume 2015:10(1) Pages 1443—1454

DOI https://doi.org/10.2147/COPD.S85363

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Mia Nielsen,1 Camilla Boslev Bårnes,1 Charlotte Suppli Ulrik1,2

1Department of Pulmonary Medicine, Hvidovre Hospital, 2University of Copenhagen, Copenhagen, Denmark

Background and objective: In recent years, the so-called asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has received much attention, not least because elderly individuals may present characteristics suggesting a diagnosis of both asthma and COPD. At present, ACOS is described clinically as persistent airflow limitation combined with features of both asthma and COPD. The aim of this paper is, therefore, to review the currently available literature focusing on symptoms and clinical characteristics of patients regarded as having ACOS.
Methods: Based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a systematic literature review was performed.
Results: A total of 11 studies met the inclusion criteria for the present review. All studies dealing with dyspnea (self-reported or assessed by the Medical Research Council dyspnea scale) reported more dyspnea among patients classified as having ACOS compared to the COPD and asthma groups. In line with this, ACOS patients have more concomitant wheezing and seem to have more cough and sputum production. Compared to COPD-only patients, the ACOS patients were found to have lower FEV1% predicted and FEV1/FVC ratio in spite of lower mean life-time tobacco exposure. Furthermore, studies have revealed that ACOS patients seem to have not only more frequent but also more severe exacerbations. Comorbidity, not least diabetes, has also been reported in a few studies, with a higher prevalence among ACOS patients. However, it should be acknowledged that only a limited number of studies have addressed the various comorbidities in patients with ACOS.
Conclusion: The available studies indicate that ACOS patients may have more symptoms and a higher exacerbation rate than patients with asthma and COPD only, and by that, probably a higher overall respiratory-related morbidity. Similar to patients with COPD, ACOS patients seem to have a high occurrence of comorbidity, including diabetes. Further research into the ACOS, not least from well-defined prospective studies, is clearly needed.

Keywords: ACOS, asthma, COPD, symptoms, characteristics

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Do telemedical interventions improve quality of life in patients with COPD? A systematic review

Gregersen TL, Green A, Frausing E, Ringbæk T, Brøndum E, Suppli Ulrik C

International Journal of Chronic Obstructive Pulmonary Disease 2016, 11:809-822

Published Date: 21 April 2016

Beta-blockers: friend or foe in asthma?

Arboe B, Ulrik CS

International Journal of General Medicine 2013, 6:549-555

Published Date: 8 July 2013

Long-term survival in patients hospitalized for chronic obstructive pulmonary disease: a prospective observational study in the Nordic countries

Gudmundsson G, Ulrik CS, Gislason T, Lindberg E, Brøndum E, Bakke P, Janson C

International Journal of Chronic Obstructive Pulmonary Disease 2012, 7:571-576

Published Date: 14 September 2012

Asthma and obesity: does weight loss improve asthma control? a systematic review

Juel CTB, Ali Z, Nilas L, Ulrik CS

Journal of Asthma and Allergy 2012, 5:21-26

Published Date: 7 June 2012

Early detection of COPD in general practice

Charlotte Suppli Ulrik, Anders Løkke, Ronald Dahl, et al

International Journal of Chronic Obstructive Pulmonary Disease 2011, 6:123-127

Published Date: 28 January 2011

Readers of this article also read:

Is a previous diagnosis of asthma a reliable criterion for asthma–COPD overlap syndrome in a patient with COPD?

Barrecheguren M, Román-Rodríguez M, Miravitlles M

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1745-1752

Published Date: 1 September 2015

What pulmonologists think about the asthma–COPD overlap syndrome

Miravitlles M, Alcázar B, Alvarez FJ, Bazús T, Calle M, Casanova C, Cisneros C, de-Torres JP, Entrenas LM, Esteban C, García-Sidro P, Cosio BG, Huerta A, Iriberri M, Izquierdo JL, López-Viña A, López-Campos JL, Martínez-Moragón E, Pérez de Llano L, Perpiñá M, Ros JA, Serrano J, Soler-Cataluña JJ, Torrego A, Urrutia I, Plaza V

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1321-1330

Published Date: 15 July 2015

Corrigendum: Softec HD hydrophilic acrylic intraocular lens: biocompatibility and precision

Espandar L, Sikder S, Moshirfar M

Clinical Ophthalmology 2011, 5:159-160

Published Date: 6 February 2011

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010