The term asthma-COPD overlap (ACO) has been used to identify a heterogeneous condition in which patients present with airflow limitation that is not completely reversible and clinical and inflammatory features of both asthma and chronic obstructive pulmonary disease (COPD). ACO diagnosis may be difficult in clinical practice, while controversy still exists regarding its definition, pathophysiology, and impact. Patients with ACO experience a greater disease burden compared to patients with asthma or COPD alone, but in contrast they show better response to inhaled corticosteroid treatment than other COPD phenotypes. Current management recommendations focus on defining specific and measurable treatable clinical traits, according to disease phenotypes and underlying biological mechanisms for every single patient. In this publication, we review the current knowledge on definition, pathophysiology, clinical characteristics, and management options of ACO.
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http://dx.doi.org/10.3390/jpm12050708 | DOI Listing |
Monaldi Arch Chest Dis
January 2025
Department of Community Medicine, K.S. Hegde Medical College, Deralakatte, Karnataka.
The term "asthma-chronic obstructive pulmonary disease (COPD) combined phenotype" describes patients with persistent airflow limitation and features of both asthma and COPD. There is a lack of data on effective treatments for this group, often excluded from asthma or COPD trials. Inhaled corticosteroids (ICS) are standard for asthma, while bronchodilators are key for COPD.
View Article and Find Full Text PDFRespirology
January 2025
School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.
Background And Objective: Asthma-COPD overlap (ACO) is characterized by patients exhibiting features of both asthma and COPD. Currently, there is no specific treatment for ACO. This study aimed to investigate the therapeutic potential of targeting CD131, a shared receptor subunit for IL-3, IL-5 and GM-CSF, in ACO development and in preventing acute viral exacerbations.
View Article and Find Full Text PDFAnn Allergy Asthma Immunol
January 2025
Global Medical Affairs, Specialty Care, GSK, London, UK. Electronic address:
Background: Some patients with severe asthma have overlapping allergic and eosinophilic phenotypes and may be eligible for anti-eosinophilic or anti-IgE biologics.
Objective: This post hoc sub-analysis assessed real-world mepolizumab effectiveness in patients with overlapping allergic and eosinophilic phenotypes, using 1-year data from the international, prospective REALITI-A study.
Methods: The clinically significant asthma exacerbation (CSE) rate was assessed 1 year prior to (pre-treatment) and following (follow-up) mepolizumab treatment, stratified by baseline total IgE levels (tIgE; <60, 60-<190, 190-<550, and ≥550 kU/L), atopic status (yes/no/unknown), prior omalizumab use (yes/no), geographic baseline omalizumab eligibility (eligible/non-eligible), and baseline tIgE level and blood eosinophil count (BEC) threshold combinations (<81 or ≥81 kU/L and <300 or ≥300 cells/µL).
Heart Lung
January 2025
Adelson School of Medicine, Ariel University, 3 Kiryat Hamada St., Ariel, Israel; Pulmonary Clinic, Dan- Petah-Tiqwa District, Clalit Health Services Community Division, 25 Hamytar St., Ramat-Gan, Israel. Electronic address:
Background: Confounding reports of cardiovascular disease (CVD) with the use of Inhaled corticosteroids (ICS), long-acting beta-agonists, and muscarinic antagonists (LABA and LAMA) have been reported.
Objective: To explore the relationship between the purchase of ICS, LABA and LAMA inhalers and the incidence of CVDs.
Methods: This retrospective study included patients with COPD and/or asthma, aged ≥ 18 years, who purchased LABA, LAMA, and ICS inhalers alone or in combination between 2017 and 2019.
BMJ Open Respir Res
December 2024
Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Université de Bordeaux, Bordeaux, France.
Introduction: Biologics provide significant benefits in asthma, reducing exacerbations and symptoms. Some biologics have shown promising results in small subgroups of patients with chronic obstructive pulmonary disease (COPD) and frequent exacerbations. Nevertheless, real-life data on the size of the COPD target population remain scarce.
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