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Asthma and Comorbid Conditions-Pulmonary Comorbidity
Peter G Gibson1, Vanessa M McDonald1, Ann Granchelli2
1Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia.
The Journal of Allergy and Clinical Immunology. in Practice
|September 7, 2021
Summary
Pulmonary comorbidities complicate asthma management, increasing severity and costs. Identifying and treating conditions like vocal cord dysfunction and asthma-COPD overlap can improve patient outcomes.
Area of Science:
- Pulmonology
- Respiratory Medicine
Background:
- Pulmonary comorbidities significantly impact asthma severity and healthcare costs.
- Common comorbidities include vocal cord dysfunction/inducible laryngeal obstruction, dysfunctional breathing (DB), asthma-chronic obstructive pulmonary disease overlap (ACO), and bronchiectasis.
Purpose of the Study:
- To review the impact of pulmonary comorbidities on asthma management.
- To highlight diagnostic and therapeutic strategies for common asthma comorbidities.
Main Methods:
- Literature review of studies on asthma comorbidities.
- Discussion of diagnostic approaches like continuous laryngoscopy for vocal cord dysfunction.
- Outline of treatment strategies including breathing retraining for DB and triple inhaler therapy for ACO.
Main Results:
- Vocal cord dysfunction presents as dyspnea unresponsive to bronchodilators, with inspiratory stridor.
- Dysfunctional breathing affects up to 30% of asthma patients, improving with breathing retraining.
- Asthma-COPD overlap requires consideration of triple inhaler therapy for severe cases.
- Bronchiectasis occurs in up to 30% of adults with long-standing asthma.
Conclusions:
- Pulmonary comorbidities add complexity to asthma care.
- The treatable traits strategy offers a framework for managing heterogeneous asthma with comorbidities.
- Integrated management addressing comorbidities is crucial for optimizing asthma care.
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