Interní Med. 2019; 21(1): 8-13 | DOI: 10.36290/int.2019.002

Diagnosis and treatment of asthma‑COPD overlap (ACO)

doc. MUDr. Norbert Pauk, Ph.D.

Klinika pneumologie a hrudní chirurgie Nemocnice Na Bulovce a 3. LF UK Praha

Chronic obstructive pulmonary disease (COPD) and bronchial asthma are both chronic inflammatory diseases primarily of the bronchi, but there are heterogeneous syndromes which may coexist and produce atypical phenotypes of the diseases. Currently, we know of asthma-chronic obstructive disease overlap (ACO). There have been great efforts by pneumologists to develop universal guidelines on how to name, diagnose, and treat this condition. Among obstructive pulmonary diseases, the prevalence of ACO is estimated to be between 7 and 20%. These patients often have more symptoms than those who have just bronchial asthma or COPD, with the risks of ACO being a combination of COPD and asthma risks. The patients tend to be younger than those with COPD, and the number and severity of their exacerbations are greater; therefore, pharmacotherapeutic interventions require a more integrated approach. It is vital to plan prospective and randomized studies for ACO, as until now studies have ignored this overlap and strictly separated patients with COPD from those with bronchial asthma. Currently, in the Czech Republic, there are national guidelines on how to diagnose and treat the ACO phenotype.

Keywords: ACO, COPD, GINA, GOLD, ICS, LABA, LAMA, ACO treatment

Published: February 21, 2019  Show citation