Therapeutic approaches to asthma-chronic obstructive pulmonary disease overlap

ABSTRACT

Introduction: Patients with features of both asthma and chronic obstructive pulmonary disease (COPD) (‘asthma-COPD overlap’) experience greater symptom burden and higher risk of adverse health outcomes than those with asthma or COPD alone. However, virtually no pharmacotherapy studies have been performed in this overlap population, leading to confusion amongst clinicians regarding therapeutic approaches.

Areas covered: A pragmatic approach is suggested to identify patients with typical asthma, typical COPD, and those with overlap features. Interim clinical guidance on the treatment of asthma-COPD overlap is provided, acknowledging that these recommendations are based on expert opinion given the paucity of available evidence.

Expert commentary: There is an urgent need for new studies in patients with asthma-COPD overlap to evaluate the efficacy and safety of existing pharmacotherapeutic options. Multiple underlying mechanisms are likely to contribute to the development of asthma-COPD overlap and a greater understanding of these mechanisms may allow a personalised approach to therapy in the future.

KEYWORDS:

• Asthma
• chronic obstructive pulmonary disease
• asthma-COPD overlap
• airways disease

Declaration of interest

E Lau reports personal fees and research grants from Actelion, personal fees from Menarini, outside of the submitted work. H Reddel reports research grants and personal fees from AstraZeneca, research grants, personal fees and non-financial support from GlaxoSmithKline, and personal fees from Boehringer-Ingelheim, Merck, Mundipharma, Novartis and Teva, outside of the submitted work. She is Chair of the Global Initiative for Asthma (GINA) Scientific Committee. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

This paper was not funded.