Consensus on the Asthma-COPD Overlap Syndrome (ACOS) Between the Spanish COPD Guidelines (GesEPOC) and the Spanish Guidelines on the Management of Asthma (GEMA).

Abstract

Following a proposal by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), sponsor of the Spanish COPD Guidelines (GesEPOC) and the Spanish Guidelines on the Management of Asthma (GEMA), authors of both papers have unified the criteria for the diagnosis of asthma-COPD overlap syndrome (ACOS). This consensus defines ACOS as the presence in a given patient of three elements: significant smoking exposure, chronic airflow limitation and asthma. Diagnosis is confirmed when a patient (35years of age or older), smoker or ex-smoker of more than 10 pack-years, presents airflow limitation (post-bronchodilator FEV1/FVC<0.7) that persists after treatment with bronchodilators and inhaled corticosteroids (even after systemic corticosteroids in selected cases), and an objective current diagnosis of asthma (according to GEMA criteria). In cases in which the diagnosis of asthma cannot be demonstrated, marked positive results on a bronchodilator test (FEV1≥15% and ≥400mL) or elevated blood eosinophil count (≥300eosinophils/μL) will also be diagnostic of ACOS. The opinion of another 33 experts who had not participated in the consensus was sought using a modified Delphi survey. Up to 80% of respondents gave a very positive opinion of the consensus, and declared that it was better than other previous proposals. The GesEPOC-GEMA consensus on ACOS provides a unique perspective of the diagnostic problem, using a simple proposal and a pragmatic diagnostic algorithm that can be applied at any healthcare level.

• Authors: Vicente Plaza, Francisco Álvarez, Myriam Calle, Ciro Casanova, Borja G Cosío, Antolín López-Viña, Luís Pérez de Llano, Santiago Quirce, Miguel Román-Rodríguez, Juan José Soler-Cataluña, Marc Miravitlles
• Journal: Archivos de bronconeumologia (Arch Bronconeumol) Vol. 53 Issue 8 Pg. 443-449 (Aug 2017) ISSN: 1579-2129 [Electronic] Spain
• Vernacular Title: Consenso sobre el solapamiento de asma y EPOC (ACO) entre la Guía española de la EPOC (GesEPOC) y la Guía Española para el Manejo del Asma (GEMA).
• PMID: 28495077 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Chemical References

• Anti-Asthmatic Agents
• Anti-Inflammatory Agents
• Bronchodilator Agents

Topics

• Airway Obstruction (etiology)
• Algorithms
• Anti-Asthmatic Agents (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Asthma (diagnosis, epidemiology, therapy)
• Bronchodilator Agents (therapeutic use)
• Combined Modality Therapy
• Comorbidity
• Consensus
• Consensus Development Conferences as Topic
• Cross-Sectional Studies
• Delphi Technique
• Eosinophilia (etiology)
• Expert Testimony
• Humans
• Oxygen Inhalation Therapy
• Practice Guidelines as Topic
• Pulmonary Disease, Chronic Obstructive (diagnosis, epidemiology, therapy)
• Smoking (adverse effects, epidemiology)
• Smoking Cessation
• Spirometry