Good definitions, research lacking for COPD-asthma overlap

There is disagreement in published definitions: One set of definitions includes a criterion of fractional exhaled nitric oxide not seen in any other definitions, whereas some other definitions require a history of smoking while others don’t, he said.

“How does one manage a disease without a definition and without clinical studies? It’s impossible for me to know,” Dr. Peebles said.

A commentary piece published in 2016, he noted, called for the term ACOS to be “abandoned” and then replaced when new phenotypes and underlying subtypes are identified and when “a new taxonomy of airway diseases is generated.” Dr. Peebles said he agreed with this suggestion.

Jeffrey Drazen, MD, the Distinguished Parker B. Francis Professor of Medicine at Harvard Medical School, Boston, and the editor of the New England Journal of Medicine, also lamented the polar nature of the research.