Study: Many Newly Diagnosed COPD Patients Could Have Asthma/COPD Overlap

A recent study found that asthma and chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is prevalent in newly diagnosed COPD patients.

The study included 241 general practitioners who screened a total of 3875 patients, aged 35 to 92 years, for at least one respiratory symptom, tobacco exposure, and no former obstructive lung disease diagnosis. Current tobacco use was identified in 2390 participants, and 1485 participants were ex-smokers.

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“Possible ACOS was defined as chronic airflow obstruction, ie, post-bronchodilator (BD) forced expiratory volume 1/forced vital capacity (FEV1/FVC) ratio<0.70, combined with wheeze (ACOS wheeze) and/or significant bronchodilator (BD) reversibility (ACOS BD reversibility),” the researchers wrote.

COPD was diagnosed in 700 patients, and ACOS was diagnosed in 264 of patients with COPD (38%). Prevalent ACOS wheeze was present in 190 patients (27%), and ACOS BD reversibility was present in 113 patients (16%). Only 39 patients with COPD fulfilled both criteria for ACOS (6%).

Researchers noted that ACOS patients were younger, had more dyspnea, and lower FEV/FVC ratio compared to patients with only COPD.

However, there was not significant differences in comparisons between patients who fulfilled both criteria to patients who only fulfilled the ACOS wheezing or ACOS BD reversibility criterion. Likewise, life-time tobacco exposure did not reveal any significant differences in ACOS and COPD only patients.

Overall, the researchers’ findings showed that asthma and COPD symptom overlap was highly prevalent in newly diagnosed COPD patients.

“When screening for COPD in general practice among patients with no previous diagnosis of obstructive lung disease, patients with possible ACOS may be identified by self-reported wheeze and/or BD reversibility,” the researchers concluded.

—Melissa Weiss


Baarnes CB, Kjeldgaard P, Nielsen M, Miravitlles M, and Ulrik CS. Identifying possible asthma-COPD overlap syndrome in patients with a new diagnosis of COPD in primary care [published January 5, 2017]. NPJ Primary Care Respiratory Medicine. doi:10.1038/npjpcrm.2016.84.