What pulmonologists think about the asthma-COPD overlap syndrome

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. We performed a survey among pulmono...

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Detalhes bibliográficos
Autores: Miravitlles, Marc|||0000-0002-9850-9520, Alcázar-Navarrete, Bernardino|||0000-0003-2356-9366, Alvarez Gutiérrez, Francisco Javier|||0000-0002-0175-2824, Bazús González, Teresa|||0000-0002-6531-5519, Calle Rubio, Myriam|||0000-0002-3890-2742, Casanova, Ciro|||0000-0001-7364-7508, Cisneros, Carolina|||0000-0003-4297-4199, De Torres, Juan Pablo|||0000-0003-1231-4894, Entrenas Costa, Luis M.|||0000-0003-0664-5531, Esteban, Cristóbal, García-Sidro, Patricia, Cosio, Borja G.|||0000-0002-6388-8209, Huerta, Arturo|||0000-0002-6191-4143, Iriberri, Milagros, Izquierdo Alonso, José Luis, López Viña, Antolín|||0000-0001-8057-6947, López Campos, José Luis|||0000-0003-1703-1367, Martínez-Moragón, Eva|||0000-0001-8986-9463, Pérez de Llano, Luis|||0000-0003-2652-6847, Perpiñá, Miguel, Ros, José Antonio, Serrano, José, Soler-Cataluña, Juan José|||0000-0003-1134-0783, Torrego, Alfons|||0000-0001-6624-2465, Urrutia, Isabel|||0000-0001-5386-8776, Plaza, Vicente|||0000-0003-2567-5496
Formato: artículo
Fecha de publicación:2015
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:185395
Acesso em linha:https://ddd.uab.cat/record/185395
https://dx.doi.org/urn:doi:10.2147/COPD.S88667
Access Level:acceso abierto
Palavra-chave:Asthma
COPD
ACOS
Survey
Guidelines
Descrição
Resumo: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. 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. 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 <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 β-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. 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 β-agonist/inhaled corticosteroids.

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