From the Guidelines
Asthma can contribute to the development of Chronic Obstructive Pulmonary Disease (COPD), particularly in cases of poorly controlled asthma, as it can lead to airway remodeling and irreversible airflow obstruction. According to a recent study published in Thorax in 2023 1, asthma was found to be strongly associated with the development of COPD, with patients with asthma having a 12-fold higher risk of developing COPD compared to those without asthma. This association is thought to be due to the chronic inflammation and airway remodeling that occurs in asthma, which can lead to permanent airway changes and airflow limitation.
The study also highlights the importance of proper management of asthma to prevent airway remodeling and maintain lung function. This includes the use of controller medications such as inhaled corticosteroids and bronchodilators, as well as regular follow-up with healthcare providers and adherence to prescribed medications. Avoiding triggers and reducing exposure to air pollution and other environmental factors that can exacerbate asthma and COPD is also crucial.
It's worth noting that while asthma and COPD are distinct respiratory conditions, some patients can have features of both conditions simultaneously, a situation called Asthma-COPD Overlap Syndrome (ACOS) 1. However, the study published in Thorax in 2023 1 provides the most recent and highest quality evidence on the association between asthma and COPD, and suggests that asthma can contribute to the development of COPD, particularly in cases of poorly controlled asthma.
Key points to consider in managing asthma and reducing the risk of developing COPD include:
- Proper management of asthma with controller medications such as inhaled corticosteroids and bronchodilators
- Regular follow-up with healthcare providers and adherence to prescribed medications
- Avoiding triggers and reducing exposure to air pollution and other environmental factors that can exacerbate asthma and COPD
- Early recognition and treatment of asthma and COPD to prevent airway remodeling and permanent airway changes.
From the Research
Asthma and COPD Relationship
- Asthma and Chronic Obstructive Pulmonary Disease (COPD) are two distinct chronic lung diseases with different pathophysiologies, but they can share similar symptoms and may coexist in some patients 2, 3.
- Adult subjects with active asthma are more likely to acquire COPD over time than subjects with no active asthma, suggesting a potential link between the two diseases 2.
- The nature of the association between asthma and COPD remains unclear, and further research is required to develop effective management algorithms for patients with multiple obstructive lung diseases 2.
Risk of Developing COPD in Asthma Patients
- Patients with asthma may be at a higher risk of developing COPD, especially if they have severe asthma or are exposed to certain environmental factors such as smoking 2, 3.
- Signs identifying patients with asthma predisposed to developing COPD may already be present at the early stages of the disease, highlighting the importance of early diagnosis and treatment 2.
Treatment and Management
- Inhaled corticosteroids (ICS) and long-acting beta-adrenergic agonists (LABAs) are commonly used to treat both asthma and COPD, although the response to treatment may vary between the two diseases 4, 5.
- The combination of ICS and LABA has been shown to be effective in reducing exacerbations and improving lung function in patients with asthma and COPD 4, 5.
- However, the use of LABA alone in patients with asthma increases the risk of asthma-related events, including deaths, and is not recommended as a sole treatment for asthma 4.