Asthma-COPD overlap: review of diagnosis and management

Curr Opin Pulm Med. 2020 Mar;26(2):155-161. doi: 10.1097/MCP.0000000000000649.

Abstract

Purpose of review: Asthma and chronic obstructive pulmonary disease are both commonly encountered respiratory conditions. The term asthma--COPD overlap (ACO) has been used to identify patients presenting with features of both conditions. Controversy exists regarding its definition, approach to diagnosis and management. In this publication, recent evidence has been reviewed that provides insight into diagnosis and management of this condition.

Recent findings: Previously, multiple criteria were used to define Asthma--COPD overlap. In this publication, the most recent guidelines to identify this condition have been reviewed. This publication provides a summary of the recent evidence with regard to the role of various diagnostic modalities including the use of biomarkers, such as exhaled nitric oxide, serum IgE and provides updated evidence on available treatment choices for this condition.

Summary: ACO is a commonly encountered clinical condition with patients experiencing frequent exacerbations and resulting in increased healthcare resource utilization. Recent interest in ACO has led to development of a framework towards diagnosis and management of this condition. Therapeutic choices for ACO range from bronchodilator therapy to immunomodulatory therapy, highlighting the heterogeneity of this condition. Additional research is required to improve understanding of pathogenesis and improve outcomes in ACO.

Publication types

  • Review

MeSH terms

  • Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome* / diagnosis
  • Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome* / therapy
  • Disease Management
  • Humans
  • Practice Guidelines as Topic