title: Management of the Asthma-COPD Overlap Syndrome (ACOS): a Review of the Evidence.
abstract: OBJECTIVE
  Examine the definition of the asthma-COPD overlap syndrome (ACOS) and current treatment strategies.
  
  
  RESULTS
  Patients with the ACOS have a lower quality of life and suffer from more complications than those affected by either disease alone. Diagnosis of ACOS is difficult because of the clinical similarities between the two diseases and the various phenotypes that comprise the syndrome. Defining treatment strategies for ACOS has been challenging because many clinical trials for asthma therapy have purposefully excluded patients with features of COPD, and COPD clinical trials have not included patients who might have an asthmatic component to their disease. Therefore, there are few randomized treatment trials which have included patients who have ACOS. Smoking cessation and appropriate vaccinations are cornerstone therapies, and pharmacologic therapy has focused on bronchodilators and inhaled corticosteroids. The role of biologics, such as omalizumab and IL-5 antagonists, in ACOS treatment is still being defined. As of now, with the paucity of randomized control trials guiding treatment strategies, the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend treating ACOS according to the dominant phenotype.
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, T-1218 MCN, 1161 21st Avenue South, Nashville, TN, 37232-2650, USA.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Hines
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, T-1218 MCN, 1161 21st Avenue South, Nashville, TN, 37232-2650, USA. stokes.peebles@vanderbilt.edu.
authors.forename: R Stokes
authors.initials: RS
authors.lastname: Peebles
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000517:prevention & control; D001327:Autoimmune Diseases / Q000150:complications; D001688:Biological Products / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015897:Comorbidity; D019468:Disease Management; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000517:prevention & control; D011788:Quality of Life; D016540:Smoking Cessation
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D000900:Anti-Bacterial Agents; D001688:Biological Products; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists
keywords: Asthma; COPD; Eosinophil; Pharmacotherapy; Smoking