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Tuesday, September 8, 2015

Treatment of overlapping asthma and COPD –can guidelines contribute in an evidence-free zone?

Asthma and chronic obstructive pulmonary disease (COPD) are often clearly distinguishable diseases. There are, however, many people who demonstrate features of both. This is often termed the asthma-COPD overlap syndrome (ACOS); it is clinically important since these patients have worse health outcomes than those with either disease alone do, and some existing guidelines for treatment of either disease conflict. ACOS patients have also been specifically excluded from major clinical trials related to either condition. There is thus at this time little evidence on how to treat them, many of whom present in primary care settings. Reddel highlights the urgent need for research in this area and summarizes the interim recommendations provided in a collaborative report by Global Initiative for Asthma (GINA) and Global Initiative for chronic Obstructive Lung Disease (GOLD) (J Allergy Clin Immunol 2015; 136(3): 546-552).

Patients with ACOS present widely varying clinical histories, from adult cigarette smokers with childhood-onset asthma to lifelong non-smokers with fixed airflow limitation to emphysema patients who also have allergic disease. ACOS cannot be thought of as a single disease or phenotype, yet primary care settings rarely permit in-depth diagnostic consultations, and forming clinical guidelines is challenging in the absence of relevant data from similar patient populations.

Some countries have recognized the overlap in recently published national asthma guidelines and COPD guidelines, but often only with the concept of two separate, coexisting diseases. The joint GINA/GOLD interim ACOS recommendations, first published in 2014, recognize that asthma and COPD form part of a spectrum of overlapping phenotypes of airways disease. They suggest targeting treatment on the basis of predictors of risk, which is useful given the lack of evidence for treatment efficacy or effectiveness for the ACOS-affected population, and they outline five pragmatic steps to diagnose and initially treat ACOS.


Interest in and recognition of the importance of overlapping asthma and COPD is rapidly escalating. It is urgently necessary to study broad populations with chronic respiratory disease in order to develop a precise definition for ACOS, characterize its phenotypes, and identify opportunities for targeted treatment.

17 comments:

  1. (MUST READ: HOW I GOT CURED FROM COPD)
    I am Lydia, I was diagnosed of Chronic obstructive pulmonary disease (COPD) in 2014, the doctor told me it has no permanent cure i was given medications to slow down its progress, i constantly felt my health was deteriorating as i constantly go out of breath especially when i walk or talk for long, this continued till a friend told me about how her mother got cured of COPD through herbs she bought from a South African herbal doctor Dr Ejiro, I contacted this herbal doctor via his email and he sent me the herbal medicine through courier service, when i received the herbal medicine i used it for 3 weeks as prescribed and was totally cured of COPD. Contact this herbal doctor via his email ejiroherbalcure@gmail.com or call +27617403481

    ReplyDelete
  2. I am AMANDA KARIPETRA living in USA, i have be suffering from Herpes,for
    many
    years, period of 7year,without cure. on one faithful day i saw an
    article on the internet were a woman talked about doctor ISE and how this
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    I contacted him through his email : ISESPIRITUALSPELLTEMPLE@GMAIL.COM and told
    him of my illness. This grate man cured my Herpes infection disease. He
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    Dr .ISE have the cure for HIV, Zika,HPV,ASTHMA,Diabetes,syphilis,low sperm
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    ReplyDelete
  3. I am AMANDA KARIPETRA living in USA, i have be suffering from Herpes,for
    many
    years, period of 7year,without cure. on one faithful day i saw an
    article on the internet were a woman talked about doctor ISE and how this
    doctor cured her permanently of HIV.
    I contacted him through his email : ISESPIRITUALSPELLTEMPLE@GMAIL.COM and told
    him of my illness. This grate man cured my Herpes infection disease. He
    sent me herbal medicine that healed me completely. Today I`m living
    happily and free from HERPES. I have concluded on my mind that there is no
    cure, he is the owner and founder of ISE HERB RESEARCH CENTRE[IHRC]
    Dr .ISE have the cure for HIV, Zika,HPV,ASTHMA,Diabetes,syphilis,low sperm
    count,cancer,madness,hepatitis,bacteria and parasitic infection and
    other related viral infection. He had spend 15 year's in practicing
    spiritualism,consultants, using herbs and spiritual means to cure
    illness all over the world. The main reason i am writing this testimony is
    to inform the whole world about his great deeds,and he is a Herbal Doctor
    who can cure deadly diseases. He is also a great spell caster I had not
    see any Doctor so powerful like this grate man,he had save many life.
    You can contact him via; ISESPIRITUALSPELLTEMPLE@GMAIL.COM
    or BROWNYALEXY@GMAIL.COM +2348151978888....
    Add me on face book:Kari Petra

    ReplyDelete
  4. I was diagnosed of Emphysema (copd)9 months ago which affected my breathing badly, my doctor advice me for Lungs Volume reduction surgery (LVRS) because my both upper lobes of the lungs were involved, i was making preparation for this when a friend of mine told me about a herbal doctor from Africa, Doctor Okosun who prepares herbal medicine to cure all kind of diseases including Emphysema, i contacted Doctor Okosun via his email and he sent me Emphysema herbal medicine via courier service, when i received this herbal medicine i applied it as instructed and was totally cured of Emphysema within 10 days of usage, i never had to go for the surgery again as i was totally free from emphysema, all thanks to Doctor Okosun, contact Doctor Okosun via his email: Doctorokosunspiritualtemple@gmail.com or call/whatspp him on +2348107584479..

    ReplyDelete
  5. I was diagnosed of Emphysema (copd)9 months ago which affected my breathing badly, my doctor advice me for Lungs Volume reduction surgery (LVRS) because my both upper lobes of the lungs were involved, i was making preparation for this when a friend of mine told me about a herbal doctor from Africa, Doctor Okosun who prepares herbal medicine to cure all kind of diseases including Emphysema, i contacted Doctor Okosun via his email and he sent me Emphysema herbal medicine via courier service, when i received this herbal medicine i applied it as instructed and was totally cured of Emphysema within 10 days of usage, i never had to go for the surgery again as i was totally free from emphysema, all thanks to Doctor Okosun, contact Doctor Okosun via his email: Doctorokosunspiritualtemple@gmail.com or call/whatspp him on +2348107584479.....

    ReplyDelete
  6. I was diagnosed of Emphysema (copd)9 months ago which affected my breathing badly, my doctor advice me for Lungs Volume reduction surgery (LVRS) because my both upper lobes of the lungs were involved, i was making preparation for this when a friend of mine told me about a herbal doctor from Africa, Doctor Okosun who prepares herbal medicine to cure all kind of diseases including Emphysema, i contacted Doctor Okosun via his email and he sent me Emphysema herbal medicine via courier service, when i received this herbal medicine i applied it as instructed and was totally cured of Emphysema within 10 days of usage, i never had to go for the surgery again as i was totally free from emphysema, all thanks to Doctor Okosun, contact Doctor Okosun via his email: Doctorokosunspiritualtemple@gmail.com or call/whatspp him on +2348107584479..,,

    ReplyDelete
  7. I was diagnosed of COPD in July 2014. I was on Albuterol Nebs and levalbuterol to ease the situation as i constantly go out of breath when talking or when walking, I was adviced for Lung Volume reduction surgery (LVRS) because my both upper lobes of the lungs were affected, i was making preparation for this surgery when a friend of mine told me about a traditional herbal doctor called doctor Abumere who prepares herbal medicine to cure all kind of diseases including COPD disease, When i contacted Dr Abumere his email and bought the herbal medicine I received the herbal medicine through courier service in 3days, when i received this herbal medicine i used it as prescribed and was totally cured of COPD within 18-20 days of usage, he is able to cure any kinds of disease such as 1. Diarrheal Diseases,2. HERPES 1/2,3. CANCER,4. ALS (Lou Gehrig’s disease),5. Herpatitis B,6.chronic pancreatitis,7.Emphysema,8.COPD (Chronic Obstructive Pulmonary Disease),9.asthma,10.Acute angle-closure Glaucoma,11.CHRONIC PANCREATITIS,12. Preterm Birth contact Dr Abumere via his email: abumereherbalcentre@gmail.com.

    ReplyDelete
  8. Parkinson disease has been ongoing in my family for long..I lost both parents to Parkinson and it is so much pain have not been able to get over. As we all know medically,there is no solution or cure for Parkinson disease and the cost for Medication is very expensive..Someone introduced me to a herbal Clinic(Native Medical Practitioner)in S.A.. i have spent thousands of dollars on medication..I said i will like to try them cos someone introduced me to them..they asked me sorts of questions and i answered back correctly..To cut the story short,they gave me some medicinal herbs and instructed me on how to apply theml..At first i was skeptical but i just gave it a try..I was on this herbal Medication for 4 weeks and i used the herbs according to the prescription..i decided to visit my doctor for another test..Honestly speaking, i never believe all he was saying until after the test when my doctor mention the statement that am Parkinson disease negative and my doctor was shocked as well....If you are out there suffering from this deadly disease you can also contact them via email: Healthherbalclinic@gmail.com or website on www.Healthherbalclinic.weebly.com

    ReplyDelete
  9. After been in pain and sorrow for 2years and 11months, DR.SUCCESSFUL was able to restore my life back with his herbal medicine, my good friends i have been COPD positive for 2years and everyday of my life i cry to God as i was a mother of 2 cute kids who were looking up to me, I was taking my medication from the hospital, I also did some prayers to God that he should do some miracle in my life, my friends this is a life touching story i am sharing with you all on net today, Few Months ago i was browsing on net when i found some good testimonials about DR.SUCCESSFUL herbal medicine , and someone recommended that he has cure to COPD , i always had faith that God could use someone to heal me, i contacted DR.SUCCESSFUL and i told him concerning my problem he told me not to worry that with God all things are possible and also that he was going to go on with the cure after everything DR.SUCCESSFUL he advice that i go for check again after taking the herbal medicine he gave to me the only thing i pay for was the items that he used for the preparation of the herbal medicine to see my status result and he assured me of good result, i was afraid at this point cause i never wanted someone to tell me again that i am positive, after 2days i went to the Hospital for check up and they said the result was to come out by Friday, at 11:00am on Friday the hospital Doctor called me and told me that the result was out and i am Negative, i was shocked and could not believe it, i immediately called DR.SUCCESSFUL and told him about the good news he told me to rejoice and make sure i share my testimony with my friends and that is why i am doing this do contact him on any of the following email DR.successfulcuringhome@gmail.com or dr.successfulcuringhome@outlook.com https://drsuccessfulcuring.wixsite.com/drsucessful.. or talk to him via mobile number +2349054910629 thanks once again to Dr GOD bless you abundantly…

    ReplyDelete
  10. After been in pain and sorrow for 2years and 11months, DR.SUCCESSFUL was able to restore my life back with his herbal medicine, my good friends i have been COPD positive for 2years and everyday of my life i cry to God as i was a mother of 2 cute kids who were looking up to me, I was taking my medication from the hospital, I also did some prayers to God that he should do some miracle in my life, my friends this is a life touching story i am sharing with you all on net today, Few Months ago i was browsing on net when i found some good testimonials about DR.SUCCESSFUL herbal medicine , and someone recommended that he has cure to COPD , i always had faith that God could use someone to heal me, i contacted DR.SUCCESSFUL and i told him concerning my problem he told me not to worry that with God all things are possible and also that he was going to go on with the cure after everything DR.SUCCESSFUL he advice that i go for check again after taking the herbal medicine he gave to me the only thing i pay for was the items that he used for the preparation of the herbal medicine to see my status result and he assured me of good result, i was afraid at this point cause i never wanted someone to tell me again that i am positive, after 2days i went to the Hospital for check up and they said the result was to come out by Friday, at 11:00am on Friday the hospital Doctor called me and told me that the result was out and i am Negative, i was shocked and could not believe it, i immediately called DR.SUCCESSFUL and told him about the good news he told me to rejoice and make sure i share my testimony with my friends and that is why i am doing this do contact him on any of the following email DR.successfulcuringhome@gmail.com or dr.successfulcuringhome@outlook.com https://drsuccessfulcuring.wixsite.com/drsucessful.. or talk to him via mobile number +2349054910629 thanks once again to Dr GOD bless you abundantly…

    ReplyDelete
  11. ALL THANKS TO DR WILLIAMS
    I was diagnosed of hepatitis B in 2011, I have tried all possible means to get cure but all my effort proved abortive, until a friend of mine introduced me to a herbal doctor from indian, who prepare herbal medicine to cure different kind of diseases including hepatitis b virus (HBV), when i contacted this herbal doctor via his email, he sent me hepatitis b herbal medicine via courier service, when i received the herbal medicine he gave me step by step instructions on how to apply it, when i applied it as instructed i was totally cured from the virus within 8 days of usage. any body with similar problem can Contact this great herbal doctor via his email drwilliams098765@gmail.com for advice and for his product

    ReplyDelete
  12. (EMPHYSEMA/COPD SUCCESS TREATMENT: My story)
    I'm from Nebraska USA, I was diagnosed with Emphysema in July of 2009. I may have had it for 6 months to 1 year prior to diagnosis. It started with a dry cough, shortness of breath, and fatigue. A chest x-ray confirmed it and I was placed on corticosteroids. As the disease progressed all medication stopped working, i was introduced to NewLife herbal clinic who have successful herbal treatment to Emphysema and other lungs related diseases. I spoke to few people who used the treatment here in USA and they all gave positive responses, so i immediately purchased the emphysema herbal remedy and commenced usage, i used the herbal supplement for only 7 weeks, all symptoms were reversed, herbs are truly gift from God. contact this herbal clinic via their email (newlifeherbalclinic @ gmail. com or visit www. newlifeherbalclinic. weebly. com)

    ReplyDelete
  13. WE WELCOME YOU ALL TO DEVANSH HERBAL HEALTH CARE.
    We have Quality Rick Simpson Cannabis oil, Emphysema herbs, all types of cancer cure, insomnia,hepatitis B,Diabetes,back pain,we also have the herbs that reduces stress and other illness. We are selling our products at very negotiable and workable prices. Apart from our very magnificent prices, when you buy from us, you are assured of the highest quality and purity available in the market,and we are 100% sure of our product, with a guaranteed discreet courier shipping or a special 24 hours confidential overnight delivery of the product to your address. We respect and value your privacy and will dont share your information with anyone. We offer discreet and Reliable packaging and delivery. -Fast and reliable shipment within 24hours within the US and 48 hours internationally, using courier service. Call or Text::::: +1936-2283-155, Email: devanshherbalheathcare@gmail.com for more information

    ReplyDelete
  14. Healing from COPD, i never taught dr Abumere who could ever get my COPD cured with his healing herbs, i have tried almost everything but i couldn’t find any solution on my disease, despite all these happening to me, i always spend a lot to buy a COPD drugs from hospital and taking some several medications but no relieve, until one day i was just browsing on the internet when i came across a great post of ! Jona Fran-ca who truly said that she was been diagnose with COPD and was healed that very week through the help of these great powerful healing doctor, sometime i really wonder why people called him Baba of africa herbs i never knew it was all because of the great and perfect work that he has been doing that is causing all this. so i quickly contacted him, and he ask me some few questions and he said a thing i will never forget that anyone who contacted him, is always getting his or her healing after take the herbs cure in a week so i was amazed all the time i heard that from him, so i did all things only to see that at the very day which he said i will be healed, all the strength that has left me before rush back and i became very strong and healthy, this disease almost kills my life all because of me, so i rush to hospital for the final test. So the disease and the doctor said i am COPD negative, i am very amazed and happy about the healing DR.Abumere gave to me from the ancient part of Africa, you can email him now for your own healing too at : abumereherbalcentre gmail com

    ReplyDelete
  15. WE WELCOME YOU ALL TO DEVANSH HERBAL HEALTH CARE.
    We have Quality Rick Simpson Cannabis oil and all types of cancer cure,chronic obstructive pulmonary disease (COPD), insomnia,fibroid,Diabetes,schizophrenia,back pain,we also have the herbs that reduces stress and other illness. We are selling our products at very negotiable and workable prices. Apart from our very magnificent prices, when you buy from us, you are assured of the highest quality and purity available in the market,and we are 100% sure of our product, with a guaranteed discreet courier shipping or a special 24 hours confidential overnight delivery of the product to your address. We respect and value your privacy and will dont share your information with anyone. We offer discreet and Reliable packaging and delivery. -Fast and reliable shipment within 24hours within the US and 48 hours internationally, using courier service. Call or Text::::: +1936-2283-155, Email: devanshherbalheathcare@gmail.com for more information

    ReplyDelete
  16. I want to use this medium to appreciate the admin of this page for allowing me to share my story.I believe that this will help others going through what i went through over the years to find a cure like i did. i was diagonosed of COPD which i suffered for so many years, despite the different english medications i took in order to find a cure, it didn't work. i started having complications resulting from those english medications i was taking over the years. as a result of these complications from my drugs, i went in search for a natural cure where i saw a testimony of someone who suffered the same sickness i was going through and the person got his cure through herbal medication, then, i followed the email he shared and i contacted the doctor, i got my cure as well, incase you are going through same sickness, you may contact the doctor for more information through his email: drallenchase@gmail.com

    ReplyDelete
  17. I was told I had emphysema in 1987 when I was 45 years old. I smoked for 30 years, but quit smoking as soon as I was told that I had COPD. Quitting smoking was the hardest thing I ever did. But I knew I would die if I didn't. My health was getting so bad that I needed oxygen 24/7 and was down to 92lbs. Thankfully, in 1999 I got lung volume reduction surgery. It saved my life. I no longer needed oxygen and was able to climb stairs, dance, and travel the world. That good fortune lasted for almost 13 years. I am now back on oxygen 24/7 and can't climb stairs, dance or travel the world. i searched for alternative treatment Online i was introduced to Health herbal clinic by a friend here in the United states she told me they have successful herbal treatment to Emphysema and other lungs diseases. I spoke to few people who used the treatment here in USA and they all gave a positive response, so i immediately purchased the COPD herbal formula and commenced usage, its totally unexplainable how all the symptoms totally dissapeared, my cough was gone and i no longer experience shortness of breath(dyspnea), contact this herbal clinic via their email Info@ healthherbalclinic. net Or website www. healthherbalclinic. net Herbs are truely gift from God

    ReplyDelete