Do patients with asthma–COPD overlap need specific management?

Jadwiga Wedzicha

Dr Jadwiga Wedzicha is a professor of respiratory medicine at the National Heart and Lung Institute, Imperial College London, United Kingdom, and editor in chief of the American Journal of Respiratory and Critical Care Medicine.

What is the current opinion on asthmachronic obstructive pulmonary disease (COPD) overlap? Do these patients need specific management?

Jadwiga Wedzicha, MD, PhD: Asthma–COPD overlap is not uncommon in COPD because both asthma and COPD are common disorders. And the issue is: Do these patients need specific management?

And as I said in my talk, these are the patients who need inhaled corticosteroids at an earlier stage. So, these are the group of patients [in whom] one can use a long-acting beta2-agonist (LABA)/inhaled corticosteroid (ICS) compound [preparation] on earlier. Indeed, if an asthma–COPD patient is breathless as well, significantly breathless, you will actually move to early triple therapy. That’s LABA, long-acting muscarinic antagonist (LAMA), and ICS.

Patients with asthma–COPD [overlap] also tend to have more exacerbations. So, education is very important... and treatment of their exacerbations. Technically, asthmatic patients have more treatable exacerbations, [treatable] with steroids. So, by treating exacerbations, you’re preventing lung function decline.

As for biologics, yes, I expect these are the group of patients who would respond to biologics that are being developed for asthma. And I think we will subsequently see studies performed with biologics in patients with asthma and COPD. Thank you.

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