Asthma, Chronic Obstructive Pulmonary Disease, and Mortality in the U.S. Population

Diaz-Guzman, Enrique; Khosravi, Mehdi; Mannino, David M.

doi:10.3109/15412555.2011.611200

Cited by 106 publications

(98 citation statements)

References 28 publications

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“…Also more airway complications needing oral steroids, antibiotics or hospitalizations were seen in patients with ACOS compared with those with asthma and COPD alone [De Marco et al 2007;Gibson and Simpson, 2009]. In a large study on self-reported asthma or COPD, the combination of self-reported asthma and COPD was associated with increased overall mortality [Diaz-Guzman et al 2011].…”

Section: Prognosismentioning

confidence: 99%

Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?

Slats

Taube

2015

Ther Adv Respir Dis

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Asthma and chronic obstructive pulmonary disease (COPD) are different disease entities. They are both clinical diagnoses, with diagnostic tools to discriminate between one another. However, especially in older patients (>55 years) it seems more difficult to differentiate between asthma and COPD. This has led to the definition of a new phenotype called asthma COPD overlap syndrome (ACOS). However, our understanding of ACOS is at a very preliminary stage, as most research has involved subjects with existing diagnoses of asthma or COPD from studies with different definitions for ACOS. This has led to different and sometimes opposing results between studies on several features of ACOS, also depending on the comparison with COPD alone, asthma alone or both, which are summarized in this review.We suggest not using the term ACOS for a patient with features of both asthma and COPD, but to describe a patient with chronic obstructive airway disease as completely as possible, with regard to characteristics that determine treatment response (e.g. eosinophilic inflammation) and prognosis (such as smoking status, exacerbation rate, fixed airflow limitation, hyperresponsiveness, comorbidities). This will provide a far more clinically relevant diagnosis, and would aid in research on treatment in more homogenous groups of patients with chronic airways obstruction. More research is certainly needed to develop more evidence-based definitions for this patient group and to evaluate biomarkers, which will help to further classify these patients, treat them more adequately and unravel the underlying pathophysiological mechanism.

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Section: Prognosismentioning

confidence: 99%

Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?

Slats

Taube

2015

Ther Adv Respir Dis

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“…COPD-betegek esetében az ACOS megjelenése 10-55%-ra tehető, attól függően, hogy milyen diagnosztikus kritériumok alapján készült a vizsgálat. Megfigyelhető, hogy az életkor előre-haladtával az ACOS prevalenciája emelkedik [8][9][10], míg a populáción belüli átlagos megjelenése 2%-ra tehető [11,12]. A magas prevalencia ellenére a betegek jelentős része eddig kizárásra került a kontrollált, kettős vak, illetve prospektív klinikai vizsgálatokból és az inhalatív gyógyszerek hatásossági vizsgálataiból.…”

Section: öSszefoglaló Közleményunclassified

Asthma-COPD overlap szindróma

Odler

Müller

2016

Orvosi Hetilap

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Az obstruktív tüdőbetegségek világszerte jelentős népegészségügyi problémát jelentenek, magas prevalenciájuk és a társadalmat érintő nagy szocioökonómiai költségeik miatt. Az asthma bronchiale és a krónikus obstruktív tüdőbeteg-ség krónikus légúti gyulladással járó betegségek, amelyeket légúti obstrukció jellemez, azonban külön nozológiai entitások, figyelembe véve kialakulásukat, diagnosztikájukat, a terápiás megfontolásokat és prognosztikai jellemzői-ket. A két betegség együttesen is előfordulhat, vagy az egyik állapot képes a másik jellemzőit felvéve, abba átalakulni. Ezt a kevert asthma-COPD fenotípust nevezzük asthma-COPD overlap szindrómának, amelyet úgy jellemeznek, hogy olyan perzisztáló légúti áramláskorlátozottsággal járó betegség, amely rendelkezik mind az asthma, mind a krónikus obstruktív tüdőbetegség egyes jellemzőivel. A szindróma az elmúlt években jelentős figyelmet kapott, azonban a betegek nagy része mostanáig kizárásra került a klinikai és légúti gyógyszer-hatásossági vizsgálatokból, így a jól meghatározott klinikai jellemzők és a megfelelő terápia továbbra sem ismertek. Az összefoglaló közlemény elsődleges célja az elmúlt években leírt patofiziológiai és klinikai jellemzők, terápiás megfontolások és irodalmi újdonságok bemutatása. Orv. Hetil., 2016, 157(33), 1304-1313. Kulcsszavak: ACOS overlap szindróma, COPD, asthma bronchiale, obstruktív, terápia Asthma-COPD overlap syndromeObstructive lung diseases represent a major health problem worldwide due to their high prevalence associated with elevated socioeconomic costs. Bronchial asthma and chronic obstructive pulmonary disease are chronic obstructive ventilatory disorders with airway inflammation, however they are separate nosological entities based on thedifferent development, diagnostic and therapeutic approaches, and prognostic features. However, these diseases may coexist and can be defined as the coexistence of increased variability of airflow in a patient with incompletely reversible airway obstruction. This phenotype is called asthma -chronic obstructive pulmonary disease overlap syndrome. The syndrome is a clinical and scientific challenge as the majority of these patients have been excluded from the clinical and pharmacological trials, thus well-defined clinical characteristics and therapeutic approaches are lacking. The aim of this review is to summarize the currently available literature focusing on pathophysiological and clinical features, and discuss possible therapeutic approaches of patients with asthma -chronic obstructive pulmonary disease overlap syndrome. -nél kisebb erek átmérőjének százalékos ará-nya; AA = afroamerikai; ACOS = asthma-COPD overlap szindróma; ACT = asthmakontrollteszt; BHR = fokozott válaszadó készség; BMI = testtömegindex; BODE-index = body mass index (testtömegindex), airflow obstruction (légúti obstrukció), dyspnea and exercise capacity (légszomj és terhelési kapacitás); BOLD = Burden of Obstructive Lung Diseases; CAT = COPD Assessment Test; COPD = krónikus obstruktív tüdőbe-tegség; CRP = C reaktív protei...

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“…Furthermore, the prevalence of ACOS (3.2%) was lower than COPD (6.0%) or asthma alone (5.6%) in the United States (15), whereas the percentage of patients visiting emergency departments was high for ACOS than for COPD alone in Korea (16). This is associated with utilization of a large proportion of medical resources and, in turn, leading to higher healthcare costs because hospitalizations account to the largest expenditure, thereby imposing heavy economic burdens on patients (17). Previous research conducted in urban China, 2010, 2012, and 2013 China National Health and Wellness and internet-based Survey (NHWS) revealed a high incidence of ACOS in urban China, which was associated with the greatest co-morbidity burden (P<0.05) compared with asthma and COPD along with worse healthcare outcomes (18).…”

Section: Introductionmentioning

confidence: 99%

Current situation of asthma-COPD overlap syndrome (ACOS) in Chinese patients older than 40 years with airflow limitation: rationale and design for a multicenter, cross-sectional trial (study protocol)

et al. 2016

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Asthma, Chronic Obstructive Pulmonary Disease, and Mortality in the U.S. Population

Abstract: In this analysis, subjects who report coexisting asthma and COPD have a higher risk of obstruction on spirometry and a higher risk of death during follow-up.

Cited by 106 publications

References 28 publications

Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?

Asthma and chronic obstructive pulmonary disease overlap: asthmatic chronic obstructive pulmonary disease or chronic obstructive asthma?

Asthma-COPD overlap szindróma

Current situation of asthma-COPD overlap syndrome (ACOS) in Chinese patients older than 40 years with airflow limitation: rationale and design for a multicenter, cross-sectional trial (study protocol)

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