Abstract
Chronic obstructive pulmonary disease (COPD) and bronchial asthma (AB) are chronic inflammatory conditions affecting predominantly the bronchi, but both also constitute distincly heterogeneous sydromes that may coexist and create specefic phenotypes. At present we know one syndrome of overlapping phenotype of COPD and asthma.
In spite of this being most likely a phenotype that is more common than previosly thought, its definition still remains only partially established. Its occurrence rate among the groupof obstructive pulmonary disordes is estimated to be 15-25=.
Affected patients frequently experience more pronouced complains then those with either asthma or COPD as idividual conditions. The risks associated with ACOS are a combination of those of COPD and asthma.
Patients with ACOS are younger that patients with COPD, experience higher number of exacerbations that are also more severe, explaining why an approach of more comprehensive pharmacotherapy interventions is necessary. Planning of prospective randomized trials of ACOS appears to be absolutely necessary in view of the fact that this overlap has been completely disregarded by the clinical studies conducted so far, characterised by a strčit line drawn between patients with COPD and those with asthma and vice versa.
At present, there is a recommendation in the Czech Republic how to diagnose and treat the asthma-COPD overlap phenomenon, but only the future will tell what new drugs or combinations and what dosage forms will be used to obtain improved control of this "both new and old" phenotape.