Asthma-chronic obstructive pulmonary disease overlap syndrome - Literature review and contributions towards a Portuguese consensus

被引:9
|
作者
Araujo, D. [1 ,2 ]
Padrao, E. [1 ,2 ]
Morais-Almeida, M. [3 ]
Cardoso, J. [4 ,5 ]
Pavao, F. [1 ]
Leite, R. B. [1 ,6 ]
Caldas, A. C. [1 ]
Marques, A. [2 ,7 ]
机构
[1] Univ Catolica Portuguesa, Inst Hlth Sci, Lisbon, Portugal
[2] Ctr Hosp Sao Joao, Dept Pulmonol, Porto, Portugal
[3] CUF Hosp, Allergy Ctr, Lisbon, Portugal
[4] Ctr Hosp Lisboa Cent, Dept Pulmonol, Lisbon, Portugal
[5] Nova Med Sch, Lisbon, Portugal
[6] Maastricht Univ, Fac Hlth Med & Life Sci, Maastricht, Netherlands
[7] Univ Porto, Fac Med, Porto, Portugal
关键词
Asthma; Chronic obstructive pulmonary disease; Overlap syndrome; Portuguese consensus; AIR-FLOW LIMITATION; SPUTUM EOSINOPHILIA; BRONCHODILATOR RESPONSIVENESS; NEVER-SMOKERS; LUNG-FUNCTION; COPD PATIENTS; RISK-FACTORS; PREVALENCE; BURDEN; HEALTH;
D O I
10.1016/j.rppnen.2016.11.005
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Introduction: Phenotypic overlap between the two main chronic airway pulmonary diseases, asthma and chronic obstructive pulmonary disease (COPD), has been the subject of debate for decades, and recently the nomenclature of asthma-COPD overlap syndrome (ACOS) was adopted for this condition. The definition of this entity in the literature is, however, very heterogeneous, it is therefore important to define how it applies to Portugal. Methods: A literature review of ACOS was made in a first phase resulting in the drawing up of a document that was later submitted for discussion among a panel of chronic lung diseases experts, resulting in reflexions about diagnosis, treatment and clinical guidance for ACOS patients. Results: There was a consensus among the experts that the diagnosis of ACOS should be considered in the concomitant presence of: clinical manifestations characteristic of both asthma and COPD, persistent airway obstruction (post-bronchodilator FEV1 /FVC < 0.7), positive response to bronchodilator test (increase in FEV1 of >= 200 mL and >= 12% from baseline) and current or past history of smoking or biomass exposure. In reaching diagnosis, the presence of peripheral eosinophilia (>300 eosinophils/mu L or >5% of leukocytes) and previous history of atopy should also be considered. The recommended first line pharmacological treatment in these patients is the ICS/LABA association; if symptomatic control is not achieved or in case of clinical severity, triple therapy with ICS/LABA/LAMA may be used. An effective control of the exposure to risk factors, vaccination, respiratory rehabilitation and treatment of comorbidities is also important. Conclusions: The creation of initial guidelines on ACOS, which can be applied in the Portuguese context, has an important role in the generation of a broad nationwide consensus. This will give, in the near future, a far better clinical, functional and epidemiological characterization of ACOS patients, with the ultimate goal of achieving better therapeutic guidance. (C) 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license.
引用
收藏
页码:90 / 99
页数:10
相关论文
共 50 条
  • [21] Defining Asthma-Chronic Obstructive Pulmonary Disease Overlap
    Godbout, Krystelle
    Gibson, Peter G.
    IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2022, 42 (03) : 507 - 519
  • [22] Airway hyperresponsiveness in chronic obstructive pulmonary disease: A marker of asthma-chronic obstructive pulmonary disease overlap syndrome?
    Tkacova, Ruzena
    Dai, Darlene L. Y.
    Vonk, Judith M.
    Leung, Janice M.
    Hiemstra, Pieter S.
    van den Berge, Maarten
    Kunz, Lisette
    Hollander, Zsuzsanna
    Tashkin, Donald
    Wise, Robert
    Connett, John
    Ng, Raymond
    McManus, Bruce
    Man, S. F. Paul
    Postma, Dirkje S.
    Sin, Don D.
    JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2016, 138 (06) : 1571 - +
  • [23] Imaging in Asthma-Chronic Obstructive Pulmonary Disease Overlap
    Svenningsen, Sarah
    Kirby, Miranda
    IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2022, 42 (03) : 601 - 614
  • [24] The Physiology of Asthma-Chronic Obstructive Pulmonary Disease Overlap
    Kaminsky, David A.
    Irvin, Charles G.
    IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2022, 42 (03) : 575 - 589
  • [25] Pathophysiology of Asthma-Chronic Obstructive Pulmonary Disease Overlap
    Hudler, Andi
    Holguin, Fernando
    Sharma, Sunita
    IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2022, 42 (03) : 521 - 532
  • [26] Epidemiology of Asthma-Chronic Obstructive Pulmonary Disease Overlap
    Fuhlbrigge, Anne L.
    IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA, 2022, 42 (03) : 533 - 547
  • [27] Causes of death in patients with asthma and asthma-chronic obstructive pulmonary disease overlap syndrome
    Harada, Tomoya
    Yamasaki, Akira
    Fukushima, Takehito
    Hashimoto, Kiyoshi
    Takata, Miki
    Kodani, Masahiro
    Okazaki, Ryota
    Takeda, Kenichi
    Watanabe, Masanari
    Kurai, Jun
    Shimizu, Eiji
    INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 2015, 10 : 595 - 602
  • [28] The pharmacological management of asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS)
    Albertson, Timothy E.
    Chenoweth, James A.
    Pearson, Skyler J.
    Murin, Susan
    EXPERT OPINION ON PHARMACOTHERAPY, 2020, 21 (02) : 213 - 231
  • [29] Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome Associated with Risk of Pulmonary Embolism
    Yeh, Jun-Jun
    Wang, Yu-Chiao
    Kao, Chia-Hung
    PLOS ONE, 2016, 11 (09):
  • [30] Reply to: Asthma-chronic obstructive pulmonary disease overlap syndrome: Is prediction feasible?
    Ayub, Irfan Ismail
    Arshad, Abdul Majeed
    Sekar, Prathipa
    Manimaran, Natraj
    Thangaswamy, Dhanasekar
    Chockalingam, Chandrasekar
    LUNG INDIA, 2018, 35 (06) : 541 - 543