Drug Combo for Asthma and COPD Overlap

An inhaled corticosteroid and long-acting beta2-agonist bronchodilator combination was found more beneficial for patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome (ACOS) than for those with COPD alone.

An inhaled corticosteroid and long-acting beta2-agonist bronchodilator combination was found more beneficial for patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome (ACOS) than for those with chronic obstructive pulmonary disorder (COPD) alone in a recently published comparison.

The efficacy of the treatment in both groups was assessed by investigators of the Korean Obstructive Lung Disease (KOLD) project and reported with lead author, Suh-Young Lee, MD, Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.

The investigators hope their study helps to fill an information gap created by the exclusion of asthma patients from COPD studies and COPD patients from asthma studies. They note that while bronchodilators are commonly used for both conditions, the inhaled corticosteroid (ICS) that is integral to asthma treatment is generally reserved for very severe airflow restrictions in COPD.

"Recently, patients with ACOS have been suggested to be more responsive to ICS compared to those with COPD alone, however, the benefits of ICS has rarely been examined in patients with ACOS," Lee and colleagues observe.

The study evaluated improvement of lung function in 45 subjects with ACOS and 107 with COPD alone after an initial drug wash-out period followed by a three-month regimen of an inhaled corticosteroid and long-acting beta2-agonist combination.

Lee and colleagues found that the measure of forced expiratory volume in one second (FEV1) had improved significantly more in the ACOS group, confirmed after adjustment for baseline characteristics, baseline FEV1, and for eosinophil count (which has been linked to ICS response in COPD). The greater improvement in FEV1 was particularly evident in ACOS patients with mild-to-moderate airflow limitation.

While finding that the inhalation combined product was of benefit to patients with ACOS, the investigators note, "further studies with long-term clinical outcomes such as lung function decline, exacerbations, and mortality are necessary."

The study, "Combination Therapy of Inhaled Steroids and Long-acting Beta2-agonists in Asthma-COPD Overlap Syndrome" was published online on November 8 in the International Journal of Chronic Obstructive Pulmonary Disease.

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