Treatment trends for asthma-COPD overlap syndrome patients: Findings from a real world survey

Abstract

Background Asthma and COPD overlap syndrome (ACOS) is an increasingly recognized phenotype. Since such patients are normally excluded from randomized clinical trials, the scientific evidence surrounding ACOS is scarce and a therapeutic approach remains unclear. One way of defining ACOS is a classification based on diagnoses of both asthma and COPD.

Aim Establish the prescribed treatment trends for ACOS patients.

Methods Data were analysed from USA, France, Germany, Italy, Spain and UK collected via the 2012 and 2013 Adelphi Respiratory cross-sectional surveysof primary and specialist physicians and their patients diagnosed with asthma, COPD or both.COPD patients with a concomitant diagnosis of asthma were classified as ACOS. Physicians were asked to complete a patient record form for patient and disease characteristics including prescribed respiratory treatment. Comparisons were made between ACOS vs. asthma and ACOS vs. COPD patients using chi-squaredtests.

Results 520 ACOS, 8985 asthma and 7061 COPD patients met inclusion criteria. Overall, the most commonly prescribed regimens were ICS/LABA+LAMA (ACOS 29.6%; asthma 1.5%[p<0.001]; COPD 32% [NS]), ICS/LABA (19.2%; 41.5%[p<0.001]; 16.7%[NS]), and LAMA (6.2%; 0.4%[p<0.001]; 19.4%[p<0.001]). 14.8% of ACOS patients were not prescribed an ICS product. Overall, ACOS patients had a worse symptomatic profile over the last 4 weeks and experienced more exacerbations in the past year compared with COPD and asthma patients.

Conclusions The majority of ACOS patients, as defined in this research, were prescribed treatment similar to COPD patients. Despite this there is unmet medical need and a clearer therapeutic approach for ACOS is needed.