A Belgian survey on the diagnosis of asthma-COPD overlap syndrome.

Autor:	Cataldo D; Department of Respiratory Diseases, CHU Liège, University of Liège, Liège., Corhay JL; Department of Respiratory Diseases, CHU Liège, University of Liège, Liège., Derom E; Department of Respiratory Medicine, Ghent University Hospital, Ghent., Louis R; Department of Respiratory Diseases, CHU Liège, University of Liège, Liège., Marchand E; Department of Respiratory Medicine, CHU - UCL - Namur, Université catholique de Louvain, Yvoir; Molecular Physiology Research Unit (URPhyM)-NARILIS, Laboratory of General Physiology, University of Namur, Namur., Michils A; Chest Department, Erasme University Hospital, Université Libre de Bruxelles, Brussels., Ninane V; Department of Respiratory Medicine, University Hospital Saint-Pierre, Université Libre de Bruxelles, Brussels., Peché R; Department of Respiratory Medicine, University Hospital Vésale, Montigny-le-Tilleul., Pilette C; Department of Respiratory Medicine, Cliniques universitaires St Luc, Université Catholique de Louvain, Brussels., Vincken W; Respiratory Division, University Hospital Brussels (UZ Brussel), Vrije Universiteit Brussel, Brussels., Janssens W; Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium.
Jazyk:	angličtina
Zdroj:	International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2017 Feb 13; Vol. 12, pp. 601-613. Date of Electronic Publication: 2017 Feb 13 (Print Publication: 2017).
DOI:	10.2147/COPD.S124459
Abstrakt:	Introduction: Patients with chronic airway disease may present features of both asthma and COPD, commonly referred to as asthma-COPD overlap syndrome (ACOS). Recommendations on their diagnosis are diffuse and inconsistent. This survey aimed to identify consensus on criteria for diagnosing ACOS. Methods: A Belgian expert panel developed a survey on ACOS diagnosis, which was completed by 87 pulmonologists. Answers chosen by ≥70% of survey respondents were considered as useful criteria for ACOS diagnosis. The two most frequently selected answers were considered as major criteria, others as minor criteria. The expert panel proposed a minimal requirement of two major criteria and one minor criterion for ACOS diagnosis. Respondents were also asked which criteria are important for considering inhaled corticosteroids prescription in a COPD patient. Results: To diagnose ACOS in COPD patients, major criteria were "high degree of variability in airway obstruction over time (change in forced expiratory volume in 1 second ≥400 mL)" and "high degree of response to bronchodilators (>200 mL and ≥12% predicted above baseline)". Minor criteria were "personal/family history of atopy and/or IgE sensitivity to ≥1 airborne allergen", "elevated blood/sputum eosinophil levels and/or increased fractional exhaled nitric oxide", "diagnosis of asthma <40 years of age"; "symptom variability", and "age (in favor of asthma)". To diagnose ACOS in asthma patients, major criteria were "persistence of airflow obstruction over time (forced expiratory volume in 1 second/forced vital capacity ratio <0.7)" and "exposure to noxious particles/gases, with ≥10 pack-years for (ex-)smokers"; minor criteria were "lack of response on acute bronchodilator test"; "reduced diffusion capacity"; "limited variability in airway obstruction"; "age >40 years"; "emphysema on chest computed tomography scan". Conclusion: Specific criteria were identified that may guide physicians to a more uniform diagnostic approach for ACOS in COPD or asthma patients. These criteria are largely similar to those used to prescribe inhaled corticosteroids in COPD. Competing Interests: Disclosure DC is the founder of Aquilon Pharmaceuticals, received speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis, MundiPharma, Chiesi, and GSK and received consultancy fees from AstraZeneca, Boehringer Ingelheim, and Novartis for the participation on advisory boards. J-LC received speaker fees from AstraZeneca, Boehringer Ingelheim, Novartis, and GSK and received honoraria for the participation to advisory boards organized by AstraZeneca, Novartis, GSK, and Boehringer Ingelheim. ED reports having received travel grants from Boehringer Ingelheim, GSK, and AstraZeneca to attend international congresses; has participated in advisory boards by Boehringer Ingelheim, Chiesi, Cipla, and AstraZeneca, (for which a fee was given); and has received speaker’s fees from Boehringer Ingelheim, GSK AstraZeneca, and Menarini to give scientific presentations to Belgian GP groupings (all not related to this work). His clinical department received financial support from Boehringer Ingelheim and Novartis to perform clinical studies. RL received research grants from AstraZeneca, Chiesi, GSK, and Novartis and received honoraria for advisory boards from AstraZeneca, Novartis, and Chiesi. EM received honoraria for the participation to advisory boards organized by AstraZeneca, Novartis, and Boehringer Ingelheim as well as speaker’s fee from Novartis and Boehringer Ingelheim. AM has received speaker fees from AstraZeneca, Novartis, Chiesi, GSK, and Stallergènes and received consultancy fees from AstraZeneca, Chiesi, and Novartis for the participation on advisory boards. AM received research grants from AstraZeneca, Novartis, and Chiesi. VN is member of advisory boards of Boehringer Ingelheim, GSK, Novartis, and AstraZeneca and received speakers fees for lectures for these companies. RP is member of advisory board and task forces for AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, and Novartis. CP received research grants from AstraZeneca, GSK, Novartis, Chiesi, and TEVA and has been a member of advisory boards for these companies and for MundiPharma. WV has received speaker fees or consultancy fees from AstraZeneca, Boehringer Ingelheim, Novartis, MundiPharma, Chiesi, and GSK. WJ is holder of the AZ Foundation KUL Chair in Respiratory Diseases. He received research grants from Boehringer Ingelheim, GSK, Novartis, and Chiesi. He is a member of advisory boards of Boehringer Ingelheim, GSK, Novartis, Chiesi, and AstraZeneca and received speakers fees for lectures for these companies. The authors report no other conflicts of interest in this work.
Databáze:	MEDLINE
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