What pulmonologists think about the asthma-COPD overlap syndrome

Fecha de publicación: 01/01/2015

Autores de IIS La Fe

Miguel José Perpiña Tordera

Autor

Participantes ajenos a IIS La Fe

Miravitlles, M
Alcazar, B
Alvarez, FJ
Bazus, T
Calle, M
Casanova, C
Cisneros, C
de-Torres, JP
Entrenas, LM
Esteban, C
Garcia-Sidro, P
Cosio, BG
Huerta, A
Iriberri, M
Izquierdo, JL
Lopez-Vina, A
Lopez-Campos, JL
Martinez-Moragon, E
de Llano, LP
Ros, JA
Serrano, J
Soler-Cataluna, JJ
Torrego, A
Urrutia, I
Plaza, V

Grupos

Neumología

Leader

Miguel Ángel Martínez García

Abstract

Background: 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. Materials and methods: 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. Results: 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 beta(2)-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: 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 beta(2)-agonist/inhaled corticosteroids.

Datos de la publicación

ISSN/ISSNe:: 1178-2005, 1178-2005
Tipo:: Article
Páginas:: 1321-1330
DOI:: 10.2147/COPD.S88667
PubMed:: 26270415
Factor de Impacto:: 1,245 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Keywords

asthma; COPD; ACOS; survey; guidelines

Campos de Estudio

Proyectos y Estudios Clínicos

BASES MOLECULARES Y FISIOLOGICAS DE LAS ENFERMEDADES RESPIRATORIAS. IMPLICACIONES DIAGNOSTICAS Y TERAPEUTICAS

Investigador Principal: ROSARIO MENÉNDEZ VILLANUEVA

C03/011 . INSTITUTO DE SALUD CARLOS III . 2003

INVESTIGACION COOPERATIVA DE ENFERMEDADES RESPIRATORIAS

Investigador Principal: ROSARIO MENÉNDEZ VILLANUEVA

PI05/0583 . INSTITUTO DE SALUD CARLOS III . 2006

SAS115359, UN ESTUDIO DE SEGURIDAD Y EFICACIA DE UNA COMBINACIÓN DE PROPIONATO DE FLUTICASONA/SALMETEROL INHALADA FRENTE A PROPIONATO DE FLUTICASONA INHALADO EN EL TRATAMIENTO DE SUJETOS ADOLESCENTES Y ADULTOS CON ASMA.

Investigador Principal: ANTONIO NIETO GARCÍA

SAS115359 . 2012

ENSAYO FASE III, MULTICENTRICO, ALEATORIZADO, DOBLE CIEGO, CON GRUPOS PARALELOS, CONTROLADO CON PLACEBO, DE 52 SEMANAS, PARA EVALUAR LA EFICACIA Y SEGURIDAD DE TRALOKINUMAB EN ADULTOS Y ADOLESCENTES CON ASMA INSUFICIENTEMENTE CONTROLADA CON CORTICOSTEROID ES INHALADOS MAS AGONISTAS DE ƒÀ2 DE ACCION PROLONGADA (STRATOS 1).

Investigador Principal: ALFREDO DE DIEGO DAMIÁ

D2210C00007

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