What pulmonologists think about the asthma-COPD overlap syndrome
Por:
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, Perpina, M, Ros, JA, Serrano, J, Soler-Cataluna, JJ, Torrego, A, Urrutia, I, Plaza, V
Publicada:
1 ene 2015
Resumen:
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.
Filiaciones:
Miravitlles, M:
Hosp Univ Vall dHebron, Dept Pneumol, Barcelona 08035, Spain
CIBERER Enfermedades Resp CIBERES, Madrid, Spain
Alcazar, B:
Hosp Alta Resoluc Loja, Resp Dept, Granada, Spain
Alvarez, FJ:
Virgen del Rocio Univ Hosp, Med Surg Unit Resp Dis, Biomed Inst Seville IBiS, Seville, Spain
Bazus, T:
Hosp Univ Cent Asturias, Dept Pneumol, Oviedo, Spain
Calle, M:
Hosp Clin San Carlos, Dept Pneumol, Madrid, Spain
Casanova, C:
Hosp Nuestra Senora Candelaria, Dept Pneumol, Santa Cruz De Tenerife, Spain
Cisneros, C:
Hosp Univ Princesa, Inst Invest Sanitaria IIS IP, Dept Pneumol, Madrid, Spain
de-Torres, JP:
Univ Navarra Clin, Pulm Dept, Pamplona, Spain
Entrenas, LM:
Hosp Univ Reina Sofia, Dept Pneumol, Cordoba, Spain
Esteban, C:
Hosp Galdakao Usansolo, Dept Pneumol, Galdakao, Spain
Garcia-Sidro, P:
Hosp Univ La Plana, Dept Pneumol, Vila Real, Spain
Cosio, BG:
Hosp Univ Son Espases IdISPa, Dept Pneumol, Palma De Mallorca, Spain
Huerta, A:
Hosp Clin Barcelona, Secc Urgencias Med Neumol, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona, Spain
Iriberri, M:
Hosp Univ Cruces, Dept Pneumol, Bilbao, Spain
Izquierdo, JL:
Hosp Univ Guadalajara, Dept Pneumol, Guadalajara, Spain
Lopez-Vina, A:
Hosp Univ Puerta Hierro Majadahonda, Dept Pneumol, Madrid, Spain
Lopez-Campos, JL:
CIBERER Enfermedades Resp CIBERES, Madrid, Spain
Virgen del Rocio Univ Hosp, Med Surg Unit Resp Dis, Biomed Inst Seville IBiS, Seville, Spain
Martinez-Moragon, E:
Hosp Univ Dr Peset, Dept Pneumol, Valencia, Spain
de Llano, LP:
Hosp Univ Lucus Augusti, Dept Pneumol, Lugo, Spain
Perpina, M:
Hosp Univ & Politecn La Fe, Dept Pneumol, Valencia, Spain
Ros, JA:
Hosp Clin Univ Virgen Arrinxaca, Dept Pneumol, Murcia, Spain
Serrano, J:
Hosp Comarcal Inca, Dept Pneumol, Inca, Spain
Soler-Cataluna, JJ:
Hosp Arnau Vilanova Lliria, Dept Pneumol, Valencia, Spain
Torrego, A:
Univ Autonoma Barcelona, Dept Med, Hosp Santa Creu & St Pau, Inst Invest Biomed St Pau IIB St Pau,Dept Rest Me, E-08193 Barcelona, Spain
Urrutia, I:
Hosp Galdakao Usansolo, Dept Pneumol, Galdakao, Spain
Plaza, V:
Univ Autonoma Barcelona, Dept Med, Hosp Santa Creu & St Pau, Inst Invest Biomed St Pau IIB St Pau,Dept Rest Me, E-08193 Barcelona, Spain
Gold, Green Published
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