Treatment of overlapping asthma-chronic obstructive pulmonary disease: Can guidelines contribute in an evidence-free zone?

The Journal of Allergy and Clinical Immunology
Helen K Reddel

Abstract

In their most typical forms, asthma and chronic obstructive pulmonary disease (COPD) are clearly distinguishable, but many patients with chronic airflow limitation demonstrate features of both conditions and have worse health outcomes than those with either disease alone. This has been called the asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS), but as yet, it lacks a precise definition. However, given the different pathways by which a patient can come to demonstrate features of both asthma and COPD, ACOS is not thought to represent a single disease but to include several heterogeneous phenotypes with different underlying mechanisms. These issues have important implications for guidelines because some existing treatment recommendations for asthma and COPD are in conflict, and patients with both asthma and COPD have specifically been excluded from major pharmacologic trials. As a result, there is little evidence at present to support specific treatment recommendations for ACOS on the basis of efficacy or effectiveness, yet these patients continue to present for diagnosis and management, mainly in primary care. This article highlights the need for clinical guidance about ACOS, summarizes recommendations about ...Continue Reading

References

Nov 17, 1998·American Journal of Respiratory and Critical Care Medicine·E PizzichiniF E Hargreave
Jul 7, 1999·Lancet·I D PavordA J Wardlaw
Aug 3, 2000·The New England Journal of Medicine·S SuissaB Cai
May 23, 2001·JAMA : the Journal of the American Medical Association·S C LazarusUNKNOWN Asthma Clinical Research Network for the National Heart, Lung, and Blood Institute
Dec 18, 2001·Chest·G W ChalmersN C Thomson
Jul 12, 2002·Family Practice·Peter MontnémeryE Adelroth
Apr 16, 2004·The European Respiratory Journal·M MasoliR Beasley
May 17, 2006·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Mark L LevyBarbara P Yawn
Nov 23, 2006·Respiratory Medicine·Justin TraversRichard Beasley
Nov 3, 2007·Annals of Internal Medicine·Amir QaseemUNKNOWN Clinical Efficacy Assessment Subcommittee of the American College of Physicians
Aug 30, 2008·Thorax·S E MarshR W Beasley
Nov 19, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Shawn D AaronUNKNOWN Canadian Respiratory Clinical Research Consortium
Apr 10, 2009·The European Respiratory Journal·M WeatherallR Beasley
Apr 24, 2009·Proceedings of the American Thoracic Society·Fernando D Martinez
Jan 16, 2010·The European Respiratory Journal·V P LuksS D Aaron
Jun 29, 2010·BMJ : British Medical Journal·John O'ReillyUNKNOWN Guideline Development Group
Aug 20, 2010·Respiration; International Review of Thoracic Diseases·Lea SchirnhoferMichael Studnicka
Jan 12, 2011·Respiratory Research·Nicola A HananiaDonald Tashkin
Feb 18, 2011·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Paula KauppiTarja Laitinen
Sep 29, 2011·Respiratory Research·Megan HardinUNKNOWN COPDGene Investigators
Oct 25, 2011·The Journal of Allergy and Clinical Immunology·L Keoki WilliamsManel Pladevall
Jan 28, 2012·The European Respiratory Journal·Louis-Philippe BouletEric D Bateman
Feb 1, 2013·The Clinical Respiratory Journal·Heidi AndersénTimo Keistinen
Feb 28, 2013·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Marc MiravitllesJoan B Soriano
Apr 26, 2013·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Leanne M PoulosHelen K Reddel
Jan 28, 2014·The Lancet. Respiratory Medicine·Nicolas RocheUNKNOWN Respiratory Effectiveness Group
Mar 19, 2014·American Journal of Respiratory and Critical Care Medicine·Elliot Israel, Alberto Papi
Apr 11, 2014·BioMed Research International·Mario MalerbaFabio L M Ricciardolo
Dec 18, 2014·Basic & Clinical Pharmacology & Toxicology·Hannu KankaanrantaLauri Lehtimäki

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Citations

Feb 20, 2016·Expert Opinion on Pharmacotherapy·Mario CazzolaMaria Gabriella Matera
Sep 8, 2015·The Journal of Allergy and Clinical Immunology·Arthur F Gelb, Jay A Nadel
Jul 4, 2016·The Journal of Allergy and Clinical Immunology·Mario Cazzola, Paola Rogliani
Aug 9, 2016·The Journal of Allergy and Clinical Immunology·Andrew H LiuStanley J Szefler
Nov 8, 2016·Current Opinion in Pulmonary Medicine·Maria D'AmatoGennaro D'Amato
Nov 15, 2016·Current Opinion in Allergy and Clinical Immunology·Gustavo J RodrigoVicente Plaza
Jan 7, 2017·Experimental Biology and Medicine·Hussam A MuradMohamad Nidal Khabaz
Nov 1, 2016·The Annals of Pharmacotherapy·Maithili Deshpande, Jennifer Arnoldi
Mar 11, 2017·The Journal of Allergy and Clinical Immunology·William T ShearerUNKNOWN Pediatric HIV/AIDS Cohort Study
Dec 29, 2017·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Caleb D WasserSharon R Smith
Mar 15, 2018·European Clinical Respiratory Journal·Celeste PorsbjergHannu Kankaanranta
Dec 9, 2017·The European Respiratory Journal·James FingletonUNKNOWN NZ–China Study Group
Feb 7, 2019·ERJ Open Research·Helen K ReddelJørgen Vestbo
Sep 14, 2019·The European Respiratory Journal·Richard J MartinHelen K Reddel
Apr 21, 2018·Allergy, Asthma & Immunology Research·Sang Heon KimUNKNOWN Severe Asthma Work Group, the Korean Academy of Asthma, Allergy and Clinical Immunology
Jan 21, 2020·Expert Opinion on Pharmacotherapy·Timothy E AlbertsonSusan Murin
Jun 22, 2017·American Journal of Respiratory and Critical Care Medicine·Prescott G WoodruffRobert A Wise
Feb 18, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Tunn R TayMark Hew
Feb 27, 2021·The European Respiratory Journal·Helen K ReddelUNKNOWN NOVELTY study investigators

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