Chronic obstructive pulmonary disease (COPD) and asthma
Asthma and COPD are quite distinctive and readily distinguishable from each other when they occur in their most characteristic forms. However, many adult patients show features of both these conditions.
The possibility of COPD as an alternative diagnosis and the possibility of asthma–COPD overlap should be considered during diagnostic investigation of respiratory symptoms in adults, particularly in smokers, ex-smokers and older adults.
Current asthma guidelines and COPD guidelines make contrasting recommendations for pharmacotherapy, based on differing safety findings in each population. Asthma guidelines generally recommend inhaled corticosteroids for most adults and recommend against long-acting beta2 agonist without concomitant or combination inhaled corticosteroid therapy, whereas COPD guidelines recommend a long-acting beta2 agonist as initial treatment and inhaled corticosteroids only for patients with more severe disease. Special considerations are therefore needed when a patient has features of both diagnoses.
In this section
Diagnostic considerations when COPD is a possibility
Managing asthma–COPD overlap
Management considerations for patients with asthma–COPD overlap