Clinical Approach to the Therapy of Asthma-COPD Overlap

Chest: The Journal of Circulation, Respiration and Related Systems

Megan Hardin^2¹  Craig P. Hersh^5²  Jay I. Peters^1,6³  Diego J. Maselli^1⁴  Antonio Anzueto^1,6⁵  Stephanie A. Christenson^3⁶  Nicola A. Hanania^4⁷  Sandra G. Adams^1,6⁸ 

[1] AstraZeneca LLC, Waltham, MA^2;Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA^5;Department of Medicine, Weill Cornell Medical College, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY^8;Division of Pulmonary Diseases & Critical Care Medicine, Department of Medicine, University of Texas Health at San Antonio, San Antonio, TX^1;Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI^7;Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA^3;Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX^4;South Texas Veterans Health Care System, San Antonio, TX^6

关键词: asthma;    COPD;    overlap;    therapy;    ACO;    asthma-COPD overlap;    ICS;    inhaled corticosteroid;    LABA;    long-acting β2 agonist;    LAMA;    long-acting muscarinic antagonist;   

DOI  :  10.1016/j.chest.2018.07.028

学科分类：呼吸医学

来源: American College of Chest Physicians

【 摘 要 】

Over the last few years, there has been a renewed interest in patients with characteristics of both asthma and COPD. Although the precise definition of asthma-COPD overlap (ACO) is still controversial, patients with overlapping features are frequently encountered in clinical practice, and may indeed have worse clinical outcomes and increased health-care utilization than those with asthma or COPD. Therefore, there is a critical need to set a framework for the therapeutic approach of such patients. There are key distinctions in the therapy between asthma and COPD, particularly regarding the initial choice of therapy. However, there is considerable overlap in the use of existing medications for both diseases. Furthermore, novel therapies approved for asthma, such as monoclonal antibodies, may have a role in patients with COPD and ACO. The use of biomarkers, such as peripheral blood eosinophils, exhaled nitric oxide, and serum IgE, may help in selecting appropriate therapies for ACO. In this review, we provide an overview of available treatments for both asthma and COPD and explore their potential role in the treatment of patients with ACO.

【 授权许可】

CC BY