Clinically relevant subgroups in COPD and asthma

Eur Respir Rev June 1, 2015 vol. 24 no. 136 283-298

Alice M. Turner1,2⇑, 

Lilla Tamasi3, 

Florence Schleich4, 

Mehmet Hoxha5,

Ildiko Horvath3, 

Renaud Louis4 and 

Neil Barnes6

+Author Affiliations

1. ¹Clinical and Experimental Medicine, University of Birmingham, Queen Elizabeth Hospital Birmingham, Birmingham, UK
2. ²Dept of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK
3. ³Dept of Pulmonology, Semmelweis University, Budapest, Hungary
4. ⁴Respiratory Medicine, CHU Sart-Tilman B35, Liege, Belgium
5. ⁵Service of Allergology and Clinical Immunology, UHC “Mother Teresa”, Tirana, Albania
6. ⁶GlaxoSmithKline, Stockley Park West, Uxbridge, UK

1. Alice M. Turner, Clinical and Experimental Medicine, University of Birmingham, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2WB, UK. E-mail: a.m.wood@bham.ac.uk
2. 
   
3. Abstract

As knowledge of airways disease has grown, it has become apparent that neither chronic obstructive pulmonary disease (COPD) nor asthma is a simple, easily defined disease. In the past, treatment options for both diseases were limited; thus, there was less need to define subgroups. As treatment options have grown, so has our need to predict who will respond to new drugs. To date, identifying subgroups has been largely reported by detailed clinical characterisation or differences in pathobiology. These subgroups are commonly called “phenotypes”; however, the problem of defining what constitutes a phenotype, whether this should include comorbid diseases and how to handle changes over time has led to the term being used loosely.

In this review, we describe subgroups of COPD and asthma patients whose clinical characteristics we believe have therapeutic or major prognostic implications specific to the lung, and whether these subgroups are constant over time. Finally, we will discuss whether the subgroups we describe are common to both asthma and COPD, and give some examples of how treatment might be tailored in patients where the subgroup is clear, but the label of asthma or COPD is not.

This Article

doi:10.1183/16000617.00009014

Eur Respir Rev June 1, 2015vol. 24 no. 136 283-298

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