Airflow obstruction: is it asthma or is it COPD?

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Medicine

Background:

• Diagnostic confusion between asthma and chronic obstructive pulmonary disease (COPD) is common despite existing guidelines.
• Differentiating fixed airway obstruction in asthma versus COPD presents clinical challenges.
• The overlap syndrome or mixed asthma-COPD phenotype lacks clear definition, complicating treatment strategies.

Purpose of the Study:

• To highlight the difficulties in distinguishing asthma from COPD.
• To discuss the concept and challenges of the asthma-COPD overlap syndrome.
• To advocate for personalized treatment approaches in airway obstruction.

Main Methods:

• Review of clinical presentations and diagnostic features of asthma and COPD.
• Analysis of the concept of asthma-COPD overlap syndrome.
• Discussion of current understanding of asthma and COPD as syndromes with diverse endotypes and phenotypes.

Main Results:

• Asthma and COPD share overlapping clinical features, making diagnosis difficult.
• The asthma-COPD overlap syndrome is a recognized but poorly defined entity.
• Neither asthma nor COPD are single diseases but represent a spectrum of conditions.

Conclusions:

• Effective management requires recognizing asthma and COPD as complex syndromes.
• Personalized therapy targeting treatable traits is essential for patients with airway obstruction.
• Further research is needed to clarify the asthma-COPD overlap and guide targeted treatments.