Asthma-chronic obstructive pulmonary disease overlap syndrome: clinical-functional profile

José Luis Che-Morales; Jorge Valle-Piña; Jaber Carrillo-Chana

2019, Number 5

<< Back Next >>

Rev Med Inst Mex Seguro Soc 2019; 57 (5)

Asthma-chronic obstructive pulmonary disease overlap syndrome: clinical-functional profile

Che-Morales JL, Valle-Piña J, Carrillo-Chana J

Full text

How to cite this article

Language: Spanish
References: 25
Page: 284-290
PDF size: 166.15 Kb.

ABSTRACT

Background: Asthma and Chronic Obstructive Pulmonary Disease (COPD) affects 1 in 10 individuals worldwide. Asthma and COPD overlap syndrome (ACOS) have more symptoms, exacerbations and worse pulmonary function.
Objective: To evaluate the clinical-functional profile with ACOS who are detected in a second level clinic.
Methods: Retrospective study; 466 patients 18 years and older with COPD and asthma with acceptable spirometries were analyzed. ACOS definition proposed by Montes de Oca and colleagues was used. Patients were divided in three groups: Asthma, COPD and ACOS. Differences were estimated with Chi square and ANOVA with Bonferroni´s adjustment.
Results: 79.1% were diagnosed with asthma, 8.1% COPD and 12.6% ACOS. ACOS patients were more symptomatic; the exacerbation frequency during the last year was greater (Asthma: 24.9% vs. COPD: 15.8% vs. ACOS: 39%; p = 0.036); in patients with ACOS the magnitude of change in pulmonary function was greater than those with asthma (p = 0.000). The severity of obstruction was worse among those patients with COPD and ACOS. Having medical diagnosis of ACOS, dyspnea mMRC ›2 and ACT ‹15 increased the probability of exacerbation during last the year.
Conclusion: The prevalence of ACOS was 12.6% in our group. The patients with ACOS had the worst disease control, more frequency of previous exacerbations and more severity in lung function.

REFERENCES

Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of COPD. Fontana, WI, USA: GOLD; 2018. Disponible en: http://goldcopd.org/global-strategy-diagnosismanagement- prevention-copd-2018.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2018. Disponible en: http://ginasthma.org/2018-gina-report-global-strategyfor- asthma-management-and-prevention.
Gerhardsson de Verdier M, Andersson M, Kern D, Zhou S, Tunceli O. Asthma and Chronic Obstructive Pulmonary Disease Overlap Syndrome: Doubled Costs Compare with Patient with Asthma Alone. Value Health 2015;18(6):759- 66.
Bateman E, Reddel H, N van Zyl-Smit R, Agusti A. The asthma–COPD overlap syndrome: towards a revised taxonomy of chronic airways diseases? Lancet Respir Med. 2015;3(9):719-28.
Montes de Oca M, Laucho-Contreras M, López Varela M, Casas A, Schiavi E, Mora J. Asthma COPD overlap Syndrome (ACOS) in primary Care of four Latin America Countries: the PUMA study. BMC Pulmonary Medicine. 2017;17(1):69. DOI: 10.1186/s12890-017- 0414-6.
Nielsen M, Barnes C, Ulrik C. Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review. Int J Chron Obstruct Pulmon Dis. 2015;10:1443- 54. DOI: 10.2147/COPD.S85363.
Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A. et al. ATS/ERS Task Force. Standarization of spirometry. Eur Respir J. 2005;26:319-338.
de Marco R, Pesce G, Marcon A, Accordini S, Antonicelli L, Bugiani M, et al. The coexistence of asthma and chronic obstructive pulmonary disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population. PloS One. 2013;8(5):e62985. DOI: 10.1371/journal.pone.0062985.
Lee J, Haselkorn T, Borish L, Rasouliyan L, Chipps B, Wenzel S, et al. Risk factors associated with persistent airflow limitation in severe or difficult-to-treat asthma: insights from the TENOR study. Chest. 2007;132(6): 1882-9.
Menezes A, Montes de Oca M, Pérez-Padilla R, Nadeau G, Wehrmeister F, López-Varela M, et al. Increased Risk of Exacerbation and Hospitalization in Subjects With an Overlap Phenotype COPD-Asthma. Chest. 2014;145(2):297-304.
Tho N, Park H, Nakano Y. Asthma-COPD overlap síndrome (ACOS): A diagnostic challenge. Respirology. 2016;21(3):410-8.
Martinez F. The origins of asthma and chronic obstructive pulmonary disease in early life. Proc Am Thorac Soc. 2009;6(3):272–7.
Shirtcliffe P, Marsh S, Travers J, Weatherall M, Beasley R. Childhood asthma and GOLD-defined chronic obstructive pulmonary disease. Intern Med J. 2012;42 (1):83-8.
Bonten T, Kasteleyn M, Mutsert R, Hiemstra P, Rosendaal F, Chavannes N, et al. Defining asthma–COPD overlap syndrome: a population-based study. Eur Respir J. 2017; 49(5):pii.1602008. DOI: 10.1183/13993003.02008-2016.
Miravitlles M, Soriano J, Ancochea J, Muñoz L, Durán- Taurelia E, Sánchez G, et al. Characterisation of the overlap COPD-asthma phenotype. Focus on physical activity and health status. Respir Med. 2013;107(7):1053-60.
Nielsen M, Boslev C, Suppli C. Clinical characteristics of the asthma–COPD overlap syndrome – a systematic review. International Journal of COPD. 2015;10:1443-54. DOI: 10.2147/COPD.S85363.
Casas-Herrera A, Montes de Oca M, López-Varela M, Aguirre C, Schiavi E, Jardim J, et al. COPD Underdiagnosis and Misdiagnosis in a High-Risk Primary Care Population in Four Latin American Countries. A Key to Enhance Disease Diagnosis: The PUMA Study. PLoS ONE. 2016; 11(4):e0152266. DOI: 10.1371/journal.pone.0152266.
Abramson M, Perret J, Dharmage S, McDonald V, McDoland C. Distinguishing adult-onset asthma from COPD: a review and a new approach. International Journal of COPD. 2014;9:945-962. DOI: 10.2147/COPD. S46761.
Zeki A, Schivo M, Chan A, Albertson T, Louie S. The asthma-COPD overlap syndrome: a common clinical problem in the elderly. J Allergy (Cairo). 2011;2011: 861926. DOI: 10.1155/2011/861926.
Dirección General de Epidemiología. Información Epidemiológica de Morbilidad. Anuario 2011. México, DF.: SUIVE/DGE/SALUD/Información Epidemiológica de Morbilidad; 2011. Disponible en: http://www.epidemiologia. salud.gob.mx/anuario/2011/morbilidad/nacional/veinte_prin cipales_causas_enfermedad_nacional_grupo_edad.pdf
Barrecheguren M, Román-Rodríguez M, Miratvilles M. Is a previous diagnosis of asthma a reliable criterion for asthma–COPD overlap syndrome in a patient with COPD? Int J Chron Obstruct Pulmon Dis. 2015;10:1745- 52. DOI: 10.2147/COPD.S87025
Tommola M, Ilmarinen P, Tuomisto L, Lehtimäki L, Haanpää J, Niemelä O, et al. Differences between asthma–COPD overlap syndrome and adult-onset asthma. Eur Respir J. 2017;49(5):pii.1602383. DOI: 10.1183/13993003.02383-2016.
Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of COPD. Fontana, WI, USA: GOLD; 2019. Disponible en: http://goldcopd.org/global-strategy-diagnosis -management-prevention-copd-2019.
Miratvilles M. Diagnosis of asthma-COPD overlap: the five commandments. Eur Respir J. 2017;49:1700506 DOI: 10.1183/13993003.00506-2017.
Cosio B, Dacal D, Pérez-de Llano L. Asthma–COPD overlap: identification and optimal treatment. Ther Adv Respir Dis. 2018;12:1-11. DOI: 10.1177/1753466618805662.