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oai:repisalud.isciii.es:20.500.12105/225302024-11-28T21:03:53Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud author García-Cosío, Borja author Dacal, David author Perez de Llano, Luis Alejandro 2024-09-06T09:53:42Z 2024-09-06T09:53:42Z 2018-10-19 Cosio BG, Dacal D, Perez De Llano L. Asthma-COPD overlap: identification and optimal treatment. Ther Adv Respir Dis. 2018 Oct 19;12:1-11. 1753-4658 http://hdl.handle.net/20.500.13003/10453 https://hdl.handle.net/20.500.12105/22530 30336736 10.1177/1753466618805662 1753-4666 Therapeutic Advances in Respiratory Disease 2-s2.0-85055074783 462093800001 L624497344 Asthma and chronic obstructive pulmonary disease (COPD) are both highly prevalent conditions that can coexist in the same individual: the so-called 'asthma -COPD overlap' (ACO). Its prevalence and prognosis vary widely depending on how ACO is defined in each publication, the severity of bronchial obstruction of patients included and the treatment they are receiving. Although there is a lack of evidence about the biology of ACO, the overlap of both diseases should express a mixture of a Th1 inflammatory pattern (characteristic of COPD) and a Th2 signature (characteristic of asthma). In this review we support a novel algorithm for ACO diagnosis proposed by the Spanish Respiratory Society (SEPAR), based on a sequential evaluation that considers: (a) the presence of chronic airflow limitation in a smoker or ex-smoker patient >= 35 years old; (b) a current diagnosis of asthma; and (c) the existence of a very positive bronchodilator test (PBT; >= 15% and >= 400 ml) or the presence of eosinophilia in blood (>= 300 eosinophils/mu l). This algorithm can identify those patients who may benefit from a treatment with inhaled corticosteroids (ICSs) and maybe from biological drugs in a near future. In addition, it is easily applicable in clinical practice. The major disadvantage is that it groups patients with very different characteristics under the ACO's umbrella. In view of this heterogeneity, we recommend a strategy of defining specific and measurable therapeutic objectives for every single patient and identifying the traits that can be treated to achieve those objectives. eng asthma COPD asthma-COPD overlap Asthma-COPD overlap: identification and optimal treatment review article