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

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 desc...

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Autores principales: Nielsen, Mia, Bårnes, Camilla Boslev, Ulrik, Charlotte Suppli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524387/
https://www.ncbi.nlm.nih.gov/pubmed/26251584
http://dx.doi.org/10.2147/COPD.S85363
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author Nielsen, Mia
Bårnes, Camilla Boslev
Ulrik, Charlotte Suppli
author_facet Nielsen, Mia
Bårnes, Camilla Boslev
Ulrik, Charlotte Suppli
author_sort Nielsen, Mia
collection PubMed
description 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 FEV(1)% predicted and FEV(1)/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.
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spelling pubmed-45243872015-08-06 Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review Nielsen, Mia Bårnes, Camilla Boslev Ulrik, Charlotte Suppli Int J Chron Obstruct Pulmon Dis Review 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 FEV(1)% predicted and FEV(1)/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. Dove Medical Press 2015-07-27 /pmc/articles/PMC4524387/ /pubmed/26251584 http://dx.doi.org/10.2147/COPD.S85363 Text en © 2015 Nielsen et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Nielsen, Mia
Bårnes, Camilla Boslev
Ulrik, Charlotte Suppli
Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review
title Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review
title_full Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review
title_fullStr Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review
title_full_unstemmed Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review
title_short Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review
title_sort clinical characteristics of the asthma–copd overlap syndrome – a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524387/
https://www.ncbi.nlm.nih.gov/pubmed/26251584
http://dx.doi.org/10.2147/COPD.S85363
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