Clinically relevant subgroups in COPD and asthma.

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Therapeutics

Background:

• Chronic obstructive pulmonary disease (COPD) and asthma are complex airway diseases, not easily defined entities.
• Limited past treatment options reduced the need for disease subtyping.
• Expanding therapeutic options necessitates predicting patient responses to new drugs.

Purpose of the Study:

• To review defined subgroups of COPD and asthma patients with significant clinical characteristics.
• To assess the therapeutic and prognostic implications of these subgroups.
• To determine if identified subgroups are consistent over time and common to both diseases.

Main Methods:

• Review of existing literature on patient subgrouping in COPD and asthma.
• Focus on clinical characterization and pathobiological differences.
• Analysis of therapeutic and prognostic relevance of identified phenotypes.

Main Results:

• Subgroup identification in airway diseases has been approached through clinical and pathobiological differences.
• The term 'phenotype' is often used loosely due to challenges in definition and temporal changes.
• This review identifies specific patient subgroups with clear therapeutic or prognostic importance.

Conclusions:

• Defining stable, clinically relevant phenotypes is essential for advancing personalized medicine in COPD and asthma.
• Understanding shared phenotypes between asthma and COPD can guide tailored treatment strategies.
• Examples of treatment tailoring for patients with unclear asthma or COPD labels but clear subgroups are discussed.