Asthma, COPD Sometimes Overlap, Specialists Say

Both conditions are separate diseases with different causes, diagnostic procedures, and treatments.

Specialists agree that a condition unofficially known as asthma-COPD overlap syndrome (ACOS) exists, according to a survey completed by Marc Miravitlles, MD, and colleagues. The participants were 26 specialists in either asthma or chronic obstructive pulmonary disease (COPD) practicing in Spain.

They first completed a structured questionnaire, and then attended an in-person work meeting that followed the Metaplan technique.

Both COPD and asthma are chronic inflammatory diseases that affect breathing, and both are characterized by bronchial obstruction, they are separate diseases with different causes, diagnostic procedures, and treatments. Given the fact that they are separate conditions, it is possible for them to co-exist.

According to the researchers, “There are currently no universally accepted, validated criteria for the diagnosis of ACOS.”

Yet, patients who have both diseases have more exacerbations, poorer health-related quality of life, worse symptoms, and greater comorbidity, and are usually excluded from clinical trials with medications.

The specialists who participated were evenly divided, with 13 specializing in COPD and 13 in asthma. The results of the questionnaire showed that 84.6% of them recognize ACOS. The majority, 80.8% of them also agreed that “the diagnostic criteria for ACOS were still not well defined.”

The second phase that participants completed was an in person, structured debate in which attendees wrote answers on cards, then a facilitator presented each card to the group and moderated the ensuing debate. This technique promoted equal participation and facilitated an orderly debate, as compared to a conventional meeting.

Participants debated several issues, including the definition of ACOS, the diagnostic criteria, the treatment, and finally, what future investigations should be conducted. Of those topics, the participants were in most agreement about future studies. Most agreed that longitudinal, populations studies and clinical trials would lead to a better definition of ACOS.