Difference Between COPD and Asthma Treatment

COPD and asthma are two of the most common chronic respiratory diseases, affecting millions of people worldwide. While both conditions share some similarities, they are distinct conditions that require different treatment approaches.

Understanding the differences between the two conditions and their respective treatments can help patients and healthcare providers effectively manage these chronic diseases.

COPD Treatment

COPD is a chronic lung disease that includes two main conditions, chronic bronchitis and emphysema.

• Chronic bronchitis is a condition that causes inflammation and narrowing of the airways, leading to coughing, excess mucus production, and difficulty breathing.

• Emphysema is a condition that damages the air sacs in the lungs, making it difficult for oxygen to be absorbed into the bloodstream.

Both conditions are usually caused by long-term exposure to irritants such as cigarette smoke, air pollution, and occupational dust and chemicals.

Risk Factors − The risk factors causing COPD are −

• Smoking;

• Air pollution;

• Frequent respiratory infections;

• Prolonged and intensive exposure to harmful substances;

• Hereditary deficiency of alpha-1-antitrypsin;

• Age;

• Gender, etc

Most of the COPD patients are men, smokers, and over 40 years old. COPD proceeds with phases of improvement and exacerbation of the condition of the patient.

Symptoms − The most common symptoms of COPD are sputum, shortness of breath, productive cough, wheezing, pain and tightness in the chest, reduced physical capacity. Symptoms are present for a long time and tend to gradually worsen. With the progressing of the disease appear cyanosis, confusion, headache, insomnia, etc.

Diagnosis − Diagnosis is made based on the clinical picture, examination, and spirometry.

Treatment − The disease cannot be cured, but the symptoms can be controlled to a certain extent. The cessation of smoking is a key point in the treatment.

The cough is a protective mechanism and it is not recommended to be suppressed. Upon exacerbation of the patient’s condition medications are prescribed, including bronchodilators, secretagogues, anti-asthma drugs, antibiotics, corticosteroids, anti-inflammatory drugs, etc. In the case of emphysema, lung volume reduction surgery and lung transplantation may be necessary.

Asthma Treatment

The asthma treatment is driven by the need to avoid/minimize asthma attacks. The aim of the treatment is to −

• Prevent the progression of the disease;

• Relieve the symptoms;

• Improve the patient’s health status;

• Prevent/minimize and treat the exacerbations;

• Maintain the function of the lungs as close to normal as possible;

• Maintain the physical activity levels as close to normal as possible;

• Prevent irreversible airflow limitations;

• Reduce mortality.

Medication − The medications used in asthma are −

• Inhaled corticosteroids − The “gold standard” in asthma treatment. They provide relieve of chronic inflammation and suppress the allergic reaction. In severe forms of asthma, as well as during a severe asthma attack, they may be administered orally or intravenously.

• Long-acting bronchodilators − Preparations of the group of Methylxanthate and long- acting beta2-receptor agonists (Theophylline, Noviline, Formoterol, Salmeterol). They provide prolonged dilatation of the bronchial tree and prevent the night attacks.

• Anti-allergic stabilizers − Used in the prophylaxis of asthma attacks – Cromoglycates, Ketotifen.

• Leukotriene antagonists − A relatively new class of drugs used in the therapy of asthma– Montelukast, etc.

• Additional treatment − Treatment of the prerequisites for the onset of asthma and its complications – antibiotics, mucolytics, secretolytics, treatment of reflux disease, etc.

There is a relatively new surgical procedure which can be applied to relieve the symptoms of asthma. It is called bronchial thermoplasty and consists in the reduction of the ability of some muscles from the airway to constrict by burning them off.

Asthma can be well controlled with a timely diagnosis and appropriate treatment. In children, it is possible to outgrow the disease as they get older.

Differences: COPD and Asthma Treatment

The treatments for COPD and asthma are different, and it is essential to understand the differences to ensure optimal management of the conditions. The mainstay of treatment for COPD is bronchodilators, which relax the smooth muscles around the airways and improve breathing.

Bronchodilators can be administered via inhalation, either as short-acting or long-acting medications. Short-acting bronchodilators, such as albuterol, provide quick relief of symptoms, while long-acting bronchodilators, such as tiotropium, provide sustained relief over a longer period. In some cases, inhaled corticosteroids may be added to the treatment regimen to reduce inflammation in the airways and prevent exacerbations.

For asthma, the mainstay of treatment is the use of inhaled corticosteroids to reduce airway inflammation. Inhaled corticosteroids are typically combined with bronchodilators, such as long- acting beta-agonists or leukotriene modifiers, to provide symptom relief and improve lung function. For patients with severe or uncontrolled asthma, biologic therapies may be used to target specific inflammatory pathways involved in the disease process.

Another significant difference between the treatment of COPD and asthma is the role of pulmonary rehabilitation. Pulmonary rehabilitation is a comprehensive program that combines exercise, education, and breathing techniques to improve lung function, reduce symptoms, and enhance quality of life. Pulmonary rehabilitation is an essential component of COPD management, as it can help patients improve their exercise tolerance and reduce the frequency of exacerbations. However, pulmonary rehabilitation is typically not recommended for asthma patients unless they have significant comorbidities, such as obesity or heart disease.

The following table highlights the major differences between COPD and Asthma Treatments −

Characteristics	COPD Treatment	Asthma Treatment
Aim	The treatment of COPD is driven by the need to control the symptoms. Its aim is to prevent the progression of the disease, relieve the symptoms, improve the patient’s health status, prevent/minimize and treat the exacerbations and complications, improve the tolerance to physical activities, reduce mortality.	The treatment of asthma is driven by the need to avoid/minimize asthma attacks. Its aim is to prevent the progression of the disease, relieve the symptoms, improve the patient’s health status, prevent/minimize and treat the exacerbations, maintain the function of the lungs as close to normal as possible, maintain the physical activity levels as close to normal as possible, prevent irreversible airflow limitations, reduce mortality.
Behavior	Behavior In COPD, it is important to reduce the exposure to risk factors, including tobacco smoke, occupational exposures, air pollution. The most important thing is to quit smoking. For patients with asthma, it is important to avoid their personal triggers.	For patients with asthma, it is important to avoid their personal triggers.
Medications	The medications used in COPD are long-acting bronchodilators, secretagogues, inhaled corticosteroids, antibiotics, etc. Vaccines can be used to help prevent certain respiratory infections.	The medications used in asthma are inhaled corticosteroids, long-acting bronchodilators, anti-allergic stabilizers, leukotriene antagonists, medications for treatment of the prerequisites for the onset of asthma and its complications.
Surgery	The surgery is the only definitive treatment of COPD. The possible surgical procedures are lung volume reduction surgery and lung transplantation.	Bronchial thermoplasty can be applied to relieve the symptoms of asthma. It consists in the reduction of the ability of some muscles from the airway to constrict by burning them off.

Conclusion

In summary, while COPD and asthma share some similarities, they are distinct conditions that require different treatment approaches.

The mainstay of COPD treatment is bronchodilators, while the mainstay of asthma treatment is inhaled corticosteroids. Pulmonary rehabilitation is an essential component of COPD management but is typically not recommended for asthma patients.

By understanding the differences between these two conditions and their respective treatments, patients and healthcare providers can effectively manage these chronic respiratory diseases and improve outcomes for patients.