Back to Browse Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 11 » Issue 1

The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease?

Authors Kostikas K, Clemens A, Patalano F

Received 27 February 2016

Accepted for publication 2 April 2016

Published 16 June 2016 Volume 2016:11(1) Pages 1297—1306

DOI https://doi.org/10.2147/COPD.S107307

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 6

Editor who approved publication: Dr Richard Russell

Konstantinos Kostikas, Andreas Clemens, Francesco Patalano

Novartis Pharma AG, Basel, Switzerland

Abstract: The term asthma–COPD overlap syndrome (ACOS) is one of multiple terms used to describe patients with characteristics of both COPD and asthma, representing ~20% of patients with obstructive airway diseases. The recognition of both sets of morbidities in patients is important to guide practical treatment decisions. It is widely recognized that patients with COPD and coexisting asthma present with a higher disease burden, despite the conceptual expectation that the “reversible” or “treatable” component of asthma would allow for more effective management and better outcomes. However, subcategorization into terms such as ACOS is complicated by the vast spectrum of heterogeneity that is encapsulated by asthma and COPD, resulting in different clinical clusters. In this review, we discuss the possibility that these different clusters are suboptimally described by the umbrella term “ACOS”, as this additional categorization may lead to clinical confusion and potential inappropriate use of resources. We suggest that a more clinically relevant approach would be to recognize the extreme variability and the numerous phenotypes encompassed within obstructive airway diseases, with various degrees of overlapping in individual patients. In addition, we discuss some of the evidence to be considered when making practical decisions on the treatment of patients with overlapping characteristics between COPD and asthma, as well as the potential options for phenotype and biomarker-driven management of airway disease with the aim of providing more personalized treatment for patients. Finally, we highlight the need for more evidence in patients with overlapping disease characteristics and to facilitate better characterization of potential treatment responders.

Keywords: emphysema, chronic bronchitis, COPD, asthma, ACOS, overlap syndrome

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 article by this author:

LABA/LAMA combinations versus LAMA monotherapy or LABA/ICS in COPD: a systematic review and meta-analysis

Rodrigo GJ, Price D, Anzueto A, Singh D, Altman P, Bader G, Patalano F, Fogel R, Kostikas K

International Journal of Chronic Obstructive Pulmonary Disease 2017, 12:907-922

Published Date: 17 March 2017