Asthma–COPD overlap 2015: now we are six

  title={Asthma–COPD overlap 2015: now we are six},
  author={Peter G. Gibson and Vanessa Marie McDonald},
  pages={683 - 691}
Background The overlap between asthma and COPD is increasingly recognised. This review examines the new insights, treatment and remaining knowledge gaps for asthma–COPD overlap. Method A systematic literature review of cluster analyses of asthma and COPD was performed. Articles from 2009 to the present dealing with prevalence, morbidity and treatment of asthma–COPD overlap were identified and reviewed. Results Asthma–COPD overlap was consistently recognised in studies using a variety of… 
Therapeutic approaches to asthma-chronic obstructive pulmonary disease overlap
Interim clinical guidance on the treatment of asthma-COPD overlap is provided, acknowledging that these recommendations are based on expert opinion given the paucity of available evidence.
Redefining the overlap of asthma and COPD
  • Medicine
    Drug and Therapeutics Bulletin
  • 2017
Some of the challenges in managing this heterogeneous group of patients with clinical features of asthma and COPD are considered.
Asthma COPD Overlap (ACO)
Clinical features and biomarkers to differentiate asthma, COPD, and ACO in elderly patients on the basis of the definition of GINA guideline are discussed and historical background and prevalence and treatment of ACO are described.
Defining asthma–COPD overlap syndrome: a population-based study
Assessment of the effect of different ACOS definitions on prevalence, patient characteristics and exacerbations in the asthma/COPD population concluded that consensus about ACOS definition in different care settings is urgently needed.
Prevalence and characteristics of asthma–COPD overlap syndrome identified by a stepwise approach
Patients identified as having ACOS were of significantly younger age, had a shorter duration of COPD, lower number of pack-years, better lung function, milder dyspnea symptoms, and higher peripheral blood eosinophil values compared with patients with COPD alone.
Asthma–chronic obstructive pulmonary disease overlap syndrome: a controversial concept
The authors concluded that the term ACOS should be avoided in the case of patients with features of both asthma and COPD, because it has no influence on the prognosis and treatment of these patients.
Asthma-COPD Overlap.
Asthma-COPD Overlap Syndrome : a review of current knowledge and future directions
Current definitions and concepts of the asthma COPD overlap syndrome are described and how the understanding of this syndrome may develop in the future is explored.
The many faces of asthma-chronic obstructive pulmonary disease overlap
ACO is a common condition with variable features and a high burden of disease and there is no consensus on its definition, diagnostic, and clinical features and more research should be done on its optimal management and long-term outcomes.
The asthma–COPD overlap syndrome: do we really need another syndrome in the already complex matrix of airway disease?
It is suggested that a more clinically relevant approach would be to recognize the extreme variability and the numerous phenotypes encompassed within obstructive airway diseases, with various degrees of overlapping in individual patients.


The overlap syndrome of asthma and COPD: what are its features and how important is it?
There is a need to re-evaluate the concept of asthma and chronic obstructive pulmonary disease (COPD) as separate conditions, and to consider situations when they may coexist, or when one condition
Systemic Inflammation in Older Adults With Asthma-COPD Overlap Syndrome
Systemic inflammation is commonly present in asthma-COPD overlap syndrome, and asthma- cephalic overlap syndrome resembled COPD in terms of systemic inflammation.
Increased risk of exacerbation and hospitalization in subjects with an overlap phenotype: COPD-asthma.
The coexisting COPD-asthma phenotype is possibly associated with increased disease severity and was associated with higher risks for exacerbations compared with those with COPD.
The clinical and genetic features of COPD-asthma overlap syndrome
Overlap subjects have more exacerbations, less emphysema and more airway disease for any degree of lung function impairment compared to COPD alone, and novel genetic variants associated with this syndrome are identified.
Eosinophilic inflammation in COPD: prevalence and clinical characteristics
Observations suggest that eosinophilic airway inflammation in COPD is a predictive biomarker of corticosteroid responsiveness during clinical stability and exacerbations.
Longitudinal Changes in Clinical Outcomes in Older Patients with Asthma, COPD and Asthma-COPD Overlap Syndrome
While spirometry, 6MWD and SGRQ deteriorated significantly over the 4 years, there was significant heterogeneity in the longitudinal changes in these clinical outcomes, and the BODE index predicted all-cause mortality in older people with OADs.
Chronic Obstructive Pulmonary Disease and Asthma–Patient Characteristics and Health Impairment
The BRFSS demonstrates different levels of health impairment among persons with COPD, asthma, overlap syndrome, and those with neither disease.
Differences in plasma and sputum biomarkers between COPD and COPD–asthma overlap
Investigating four potential biomarkers of COPD found increased induced sputum levels of NGAL might be a characteristic feature of overlap, suggesting enhanced neutrophilic airway inflammation and/or airway epithelial injury in COPD–asthma overlap.