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Defining Asthma-Chronic Obstructive Pulmonary Disease Overlap.

Krystelle Godbout¹, Peter G Gibson²

¹Quebec Heart and Lung Institute - UL, Québec, Québec, Canada.

Immunology and Allergy Clinics of North America

|August 14, 2022

Summary

Asthma-COPD overlap (ACO) is increasingly recognized but remains poorly defined, posing diagnostic challenges for clinicians. This review examines current guidance for diagnosing ACO, highlighting the need for consensus on defining features.

Keywords:

ACO Asthma Asthma–COPD overlap COPD Definition Diagnosis

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Area of Science:

Respiratory Medicine
Pulmonology
Clinical Diagnosis

Background:

Asthma-Chronic Obstructive Pulmonary Disease (COPD) overlap (ACO) has garnered significant research interest over the last 20 years.
Despite this interest, a universally accepted definition for ACO remains elusive.
Distinguishing features of asthma within a COPD diagnosis, and vice versa, presents considerable clinical challenges.

Purpose of the Study:

To review existing guidance for diagnosing Asthma-COPD overlap (ACO).
To highlight the challenges in defining ACO due to overlapping clinical features.
To discuss the lack of consensus on diagnostic criteria for ACO.

Main Methods:

Literature review of existing clinical guidance and research on ACO diagnosis.
Analysis of common and overlapping features between asthma and COPD.
Discussion of diagnostic challenges and proposed criteria for ACO.

Main Results:

While general agreement exists for some ACO cases (e.g., asthma with smoking-induced obstruction), precise diagnostic criteria are lacking.
Many asthma-like symptoms are present in COPD patients without necessarily indicating ACO.
No consensus has been reached on the specific characteristics required for an ACO definition.

Conclusions:

Diagnosing Asthma-COPD overlap (ACO) is complex due to overlapping symptomatology and lack of a standardized definition.
Current guidance aims to assist clinicians, but a consensus on ACO diagnostic criteria is still needed.
Further research and agreement are essential for accurate ACO identification and management.