The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease?
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 obs...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-06-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-asthmandashcopd-overlap-syndrome-do-we-really-need-another-syndrom-peer-reviewed-article-COPD |
| _version_ | 1811303230761598976 |
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| author | Kostikas K Clemens A Patalano F |
| author_facet | Kostikas K Clemens A Patalano F |
| author_sort | Kostikas K |
| collection | DOAJ |
| description | 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 |
| first_indexed | 2024-04-13T07:44:15Z |
| format | Article |
| id | doaj.art-026a21a78eee445dbdb07531729ab235 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-04-13T07:44:15Z |
| publishDate | 2016-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-026a21a78eee445dbdb07531729ab2352022-12-22T02:55:45ZengDove Medical PressInternational Journal of COPD1178-20052016-06-012016Issue 11297130627466The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease?Kostikas KClemens APatalano FKonstantinos 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 syndromehttps://www.dovepress.com/the-asthmandashcopd-overlap-syndrome-do-we-really-need-another-syndrom-peer-reviewed-article-COPDEmphysemachronic bronchitismixed airways diseasemixed lung diseasemixed obstruction and restriction |
| spellingShingle | Kostikas K Clemens A Patalano F The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease? International Journal of COPD Emphysema chronic bronchitis mixed airways disease mixed lung disease mixed obstruction and restriction |
| title | The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease? |
| title_full | The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease? |
| title_fullStr | The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease? |
| title_full_unstemmed | The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease? |
| title_short | The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease? |
| title_sort | asthma ndash copd overlap syndrome do we really need another syndrome in the already complex matrix of airway disease |
| topic | Emphysema chronic bronchitis mixed airways disease mixed lung disease mixed obstruction and restriction |
| url | https://www.dovepress.com/the-asthmandashcopd-overlap-syndrome-do-we-really-need-another-syndrom-peer-reviewed-article-COPD |
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