Identifying possible asthma–COPD overlap syndrome in patients with a new diagnosis of COPD in primary care

A significant proportion of patients newly diagnosed with chronic obstructive pulmonary disease probably have an asthma component to their condition. Charlotte Ulrik and co-workers at Hvidovre Hospital and the University of Copenhagen, Denmark, together with scientists in Spain, conducted a study of 3,875 patients with at least one respiratory symptom, tobacco exposure and no previous diagnosis of chronic obstructive pulmonary disease (COPD). Their aim was to characterize asthma-COPD overlap syndrome (ACOS), a recently identified condition that can lead to poor disease outcomes, and develop a definitive algorithm for GPs to use to diagnose ACOS. The team found that 700 of the cohort had COPD, 5.6 to 27.2 per cent of whom also had ACOS depending on the diagnosis criteria used. Two factors — wheezing and positive bronchodilator reversibility (lung function improvement following asthma inhaler treatment) — seemed most important in ACOS diagnosis.