|
|
Asthma
|
COPD
|
| Age of onset
|
<40 years
|
>40 years
|
| Smoking
|
Not causal
|
>10 pack-years
|
| Sputum
|
Infrequent
|
Often
|
| Allergies
|
Often
|
Infrequent
|
| Symptoms
|
Intermittent and variable
|
Persistent
|
| Course
|
Stable, with exacerbations
|
Progressive, with exacerbations
|
| Spirometry
|
Often normal
|
Never normalizes
|
Diagnostic Criteria (CTS 2017)
Required Criteria
- Diagnosis of COPD based on risk factors, history, and spirometry
- History of asthma, either as a past history or as current symptoms and spirometry consistent with asthma
- Spirometry showing post-bronchodilator fixed FEV1/FVC <0.7
Supportive Criteria
- Bronchodilator improvement in FEV1 of 12% and 200 mL
- Sputum eosinophils >3%
- Blood eosinophils > 300 cell/uL
Management
- Same non-pharmacologic/preventative management as both COPD and asthma
- For puffers, try to use ones that are good in both
- Don't use LABA monotherapy (b/c not good in asthma)
- Don't use inhaled steroid alone (b/c not good in COPD)
- Puffers:
- SABA prn
- Next add ICS/LABA
- Next add LAMA
