Tailoring Treatment in Obstructive Lung Disease: Asthma, COPD, Asthma/COPD Overlap and Eosinophilic COPD

Abstract

Obstructive lung disease exacts a huge global health burden with a high prevalence of both asthma and COPD in elderly patients. This review is to update the general and elderly care physician on diagnosis and management of COPD and asthma and the recently established disease asthma/COPD overlap (ACO) and the particular challenges treating obstructive lung disease in elderly patients. COPD pharmacology has changed considerably in the last decade with a dramatic increase in the utility of single and dual long-acting bronchodilators both for symptom and exacerbation attenuation. The emergence of ACO and the COPD phenotype eosinophilic COPD also appear to require nuanced therapeutic approaches. There is also a strong emphasis now on screening and treating comorbid conditions in COPD. In asthma the emergence of tailored therapy for different severe asthma phenotypes is also discussed. Obstructive lung diseases are very common in elderly patients and both diagnosis and treatment of these conditions is more challenging than in younger patients.