While treatments prescribed for people with chronic pulmonary disease (COPD) and asthma–COPD overlap syndrome (ACOS) are similar, there is a need for a clearer therapeutic approach for patients with ACOS, according to a new study
published in the International Journal of Chronic Obstructive Pulmonary Disease
. The research aimed to investigate the treatment trends in patients with COPD and those with ACOS while comparing the treatments between each individual disease.
COPD and asthma are respiratory conditions that cause chronic inflammation due to bronchial obstruction. ACOS patients present symptoms of both diseases, along with continuous restricted airflow and make up 12% to 55% of all chronic obstructive airway diseases.
“Despite this considerable prevalence of ACOS, few randomized controlled trials have been performed in patients with ACOS and a clear pharmacotherapeutic approach is yet to be established for ACOS,” wrote the researchers. “Furthermore, we explored the clinical characteristics of patients with ACOS compared with an asthma-only and a COPD-only population in order to better understand these patients.”
The study included 9042 asthma patients, 7119 COPD patients, and 523 patients with ACOS, collected from the 2012 and 2013 Adelphi Respiratory Disease Specific Programmes (DSPs), a large physician and patient real-world survey. Physicians completed a report based on patient demographics, clinical characteristics, clinical management, outcomes, and treatment history and use. From this survey information, the researchers could draw an analysis of similar treatments among diseases.
The study found the most common prescribed treatments among all diagnoses were inhaled corticosteroid/long-acting beta-agonist inhalers (ICS/LABA) plus long acting muscarinic antagonist (LAMA) (1.4% asthma, 32% COPD, 30% ACOS), followed by ICS/LABA (41.5% asthma, 17% COPD, 19% ACOS), and then LAMA monotherapy (0.4% asthma, 19% COPD, 6% ACOS). Significant differences between asthma and ACOS treatments are emphasized in the study, as the data demonstrates the similarities between ACOS treatments and COPD treatments as opposed to asthma-only regimens.
Due to the lack of previous research on ACOS, this study acknowledged the specific demographics of those with ACOS. The results suggested that patients with ACOS are more likely to be female and have a higher body mass index than COPD patients. When compared to asthma patients, the ACOS participants had a higher body mass index and were more likely to be current or previous smokers.
“Identification of and knowledge regarding ACOS has improved in recent times, and definitions and treatment guidelines are now available to assist in the management of affected patients,” the authors concluded. “Further research, including well-designed clinical trials in well-defined patient groups, is needed to improve outcomes in this prognostically poor patient population.”