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00925njm 22002777a 4500 dc Miravitlles, Marc author Alcazar, Bernardino author Alvarez, Francisco Javier author Bazus, Teresa author Calle, Myriam author Casanova, Ciro author Cisneros, Carolina author de-Torres, Juan P. author Entrenas, Luis M. author Esteban, Cristobal author Garcia-Sidro, Patricia author García-Cosío, Borja author Huerta, Arturo author Iriberri, Milagros author Izquierdo, Jose Luis author Lopez-Vina, Antoln author Lopez-Campos, Jose Luis author Martinez-Moragon, Eva author Perez de Llano, Luis Alejandro author Perpina, Miguel author Ros, Jose Antonio author Serrano Pariente, José author Soler-Cataluna, Juan Jose author Torrego, Alfons author Urrutia, Isabel author Plaza, Vicente author 2015 Background: Some patients with COPD may share characteristics of asthma; this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. Materials and methods: We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. Results: A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity,0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting beta(2)-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Conclusion: Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting beta(2)-agonist/inhaled corticosteroids. Miravitlles M, Alcazar B, Javier Alvarez F, Bazus T, Calle M, Casanova C, et al. What pulmonologists think about the asthma-COPD overlap syndrome. Int J Chronic Obstr Pulm Dis. 2015;10:1321-30. 10.2147/COPD.S88667 1178-2005 International Journal of Chronic Obstructive Pulmonary Disease http://hdl.handle.net/20.500.13003/17190 26270415 L605215364 2-s2.0-84937564455 http://hdl.handle.net/20.500.12105/20089 357981500001 Asthma COPD ACOS Survey Guidelines What pulmonologists think about the asthma-COPD overlap syndrome