Asthma-COPD Overlap (ACO) PRO-CON Debate. ACO: Call Me by My Name

Miravitlles, Marc

doi:10.1080/15412555.2020.1817883

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…In conclusion, despite disagreement on the definition and recognition of ACO as a distinct pathophysiological entity, 123,124 most clinicians and scientists agree that the current definitions of asthma and COPD misclassify a subgroup of patients with a different phenotype in terms of clinical presentation and, most importantly, in terms of clinical course. This is important because an appropriate identification of ACO patients may allow better-targeted therapy, and hopefully, improved clinical course, much like is currently done in asthma and COPD.…”

Section: Discussionmentioning

confidence: 98%

Update on Asthma–COPD Overlap (ACO): A Narrative Review

Mekov¹,

Núñez²,

Sin³

et al. 2021

COPD

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Although chronic obstructive pulmonary disease (COPD) and asthma are well-characterized diseases, they can coexist in a given patient. The term asthma–COPD overlap (ACO) was introduced to describe patients that have clinical features of both diseases and may represent around 25% of COPD patients and around 20% of asthma patients. Despite the increasing interest in ACO, there are still substantial controversies regarding its definition and its position within clinical guidelines for patients with obstructive lung disease. In general, most definitions indicate that ACO patients must present with non-reversible airflow limitation, significant exposure to smoking or other noxious particles or gases, together with features of asthma. In patients with a primary diagnosis of COPD, the identification of ACO has therapeutic implication because the asthmatic component should be treated with inhaled corticosteroids and some studies suggest that the most severe patients may respond to biological agents indicated for severe asthma. This manuscript aims to summarize the current state-of-the-art of ACO. The definitions, prevalence, and clinical manifestations will be reviewed and some innovative aspects, such as genetics, epigenetics, and biomarkers will be addressed. Lastly, the management and prognosis will be outlined as well as the position of ACO in the COPD and asthma guidelines.

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Section: Discussionmentioning

confidence: 98%

Update on Asthma–COPD Overlap (ACO): A Narrative Review

Mekov¹,

Núñez²,

Sin³

et al. 2021

COPD

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“… 1 First coined by Gibson et al in 2009, 2 asthma–COPD overlap (ACO) has gathered much global interest in the past decade, resulting in >350 publications on the subject within the past 5 years alone (PubMed search string as of 09 March 2021: “asthma-COPD overlap”). So why, despite this increased knowledge and interest in ACO, 3 has Global Initiative for Chronic Obstructive Lung Disease (GOLD) chosen to revise its position? 4 The answer to this may lie in the lack of a unified definition for ACO.…”

Section: Aco: No Longer Fit For Purpose?mentioning

confidence: 99%

GOLD 2021 Strategy Report: Implications for Asthma–COPD Overlap

Román-Rodríguez¹,

Kaplan²

2021

COPD

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In its 2021 strategy report, the Global Initiative for Chronic Obstructive Lung Disease states: “we no longer refer to asthma-COPD overlap (ACO), instead we emphasize that asthma and COPD are different disorders, although they may […] coexist in an individual patient. If a concurrent diagnosis of asthma is suspected, pharmacotherapy should primarily follow asthma guidelines, but pharmacological and non-pharmacological approaches may also be needed for their COPD.” What does this mean for the treating physician? In this review, we explore the implications of this new guidance on treating patients with chronic obstructive pulmonary disease, arguing for a personalized approach to treatment.

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“…Beide Krankheiten umfassen sehr heterogene Phänotypen und werden in nationalen wie internationalen Leitlinien als eigenständige Krankheitsentitäten definiert und klar voneinander abgegrenzt [1][2][3][4][5][6]. Viele Patienten mit obstruktiven Atemwegserkrankungen haben im klinischen Alltag Merkmale von Asthma und COPD, daher wurde 2014 in einem gemeinsamen GINA-GOLD-Dokument erstmals das Asthma-COPD-Overlap-Syndrom (ACOS) beschrieben "as characterized by persistent airflow limitation with several features usually associated with asthma and several features usually associated with COPD" [7,8]. Dieses Konsensuspapier sollte weitere Studien zur Charakterisierung und Behandlung von ACOS stimulieren; tatsächlich haben die Publikationen zum ACO(S) in Pubmed seitdem zugenommen, zurzeit wieder abnehmend und überwiegend Übersichtsartikel und weniger Originalarbeiten.…”

Section: Hintergrundunclassified

“…Dieses Konsensuspapier sollte weitere Studien zur Charakterisierung und Behandlung von ACOS stimulieren; tatsächlich haben die Publikationen zum ACO(S) in Pubmed seitdem zugenommen, zurzeit wieder abnehmend und überwiegend Übersichtsartikel und weniger Originalarbeiten. GOLD ist 2020 von ACO (mittlerweile ohne S) abgerückt [2,8]: "We no longer refer to asthma-COPD overlap (ACO), instead we emphasize that asthma and COPD are different disorders, although they may share common traits and clinical features (e. g. eosinophilia, some degree of reversibility)".…”

Section: Hintergrundunclassified

Asthma-COPD-Overlap – diagnostisches und therapeutisches Management

Skowasch¹,

Pizarro²

2021

Dtsch Med Wochenschr

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Asthma-COPD Overlap (ACO) PRO-CON Debate. ACO: Call Me by My Name

Cited by 12 publications

References 24 publications

Update on Asthma–COPD Overlap (ACO): A Narrative Review

Update on Asthma–COPD Overlap (ACO): A Narrative Review

GOLD 2021 Strategy Report: Implications for Asthma–COPD Overlap

Asthma-COPD-Overlap – diagnostisches und therapeutisches Management

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