HomeAnswersPulmonology (Asthma Doctors)asthma and copd overlap syndrome

Are biologic injections useful for my asthma-COPD overlap?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am a 52-year-old woman diagnosed with severe asthma overlapping with COPD, and my breathing has become unpredictable lately. Even small tasks like climbing stairs leave me short of breath. My pulmonologist recommended inhaled steroids with bronchodilators, but I am worried about long-term steroid effects, especially since I already have fragile bones. Sometimes I wheeze at night, and my rescue inhaler does not always work quickly.

  • Are biologic injections helpful for women with my type of mixed asthma-COPD condition?

  • I am also confused about which triggers I should avoid: weather changes, dust, or strong perfume?

  • I have been told to start pulmonary rehab, but I am nervous about overexerting myself.

  • I want to learn safe ways to improve my breathing without worsening my symptoms.

Kindly help...

Answered by Dr. Amandeep Singh Arneja

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Hello,

Welcome to icliniq.com.

I understand your concern.

Asthma-COPD (chronic obstructive pulmonary disease) overlap is a mix of the allergic, variable airway narrowing of asthma and the fixed airway changes of COPD. That makes breathing unpredictable, but with the right treatment plan, control is very possible.

Your pulmonologist’s advice is correct. For overlap, we use an inhaled corticosteroid (ICS) (inhaled corticosteroid) along with long-acting bronchodilators. Most patients do best on triple therapy ICS (inhaled corticosteroid) + LABA (long-acting beta agonist) + LAMA (long-acting muscarinic antagonist) in one inhaler because it reduces inflammation, keeps airways open, and prevents flare-ups.

Inhaled steroids act mainly in the lungs and are very different from oral steroids. They rarely cause whole-body side effects. To protect your bones, we keep the dose as low as possible, ensure calcium and vitamin D intake, do weight-bearing exercise, and check bone density if you already have osteoporosis. They do not usually weaken immunity or raise sugar when used correctly.

If your rescue inhaler feels slow, the problem can be severe narrowing during attacks or a technique or device mismatch. A short session to review inhaler technique often makes a big difference. In some asthma-predominant cases, a Formoterol-based inhaler can be used as both controller and reliever; this helps smooth nighttime wheeze and cut emergency visits under doctor supervision.

Biologic injections can help people whose inflammation remains active, especially with high blood eosinophils, despite good inhaler use. Your doctor can test for eosinophils or IgE (immunoglobulin E) to decide if one suits you. Many women with this overlap respond well and can lower their steroid exposure over time.

Pulmonary rehabilitation is safe and very effective. You will start with gentle, guided breathing and light walking, never beyond your comfort level. Over time, endurance and confidence improve without overexertion.

At home, practice slow breathing: inhale through your nose for two seconds, then exhale through pursed lips for four seconds. This prevents air trapping and eases breathlessness. Keep activities paced: exhale during effort, rest between steps, and avoid rushing.

Avoid triggers like cold, dry air, dust, smoke, strong perfumes, and respiratory infections. Wear a light scarf or mask outdoors in winter, maintain home humidity around 40 to 50 percent, clean with a damp cloth instead of dry dusting, and stay updated on flu and pneumococcal vaccines.

You will know treatment is working when you can climb stairs or walk longer without stopping, have fewer bad days, and sleep without nighttime wheeze. Keep a small diary of symptoms and rescue inhaler use; it helps guide adjustments.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Medically reviewed by iCliniq medical review team
Published At January 23, 2026
Reviewed At February 5, 2026

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Same symptoms don't mean you have the same problem. Consult a doctor now!

2,876Checks completed today
4.8/5User rating
~90 secAverage completion time
GINA/GOLD alignedGuideline aligned
Decision Helper
Asthma-COPD Biologics Decision Helper

Could biologic injections help your Asthma-COPD?

Answer five quick questions to understand if biologic injections are a treatment option worth discussing with your doctor.

This tool provides educational information only and does not diagnose, treat, or replace professional medical advice. Consult a qualified healthcare professional for personalized medical guidance.

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Listen to related tracks in our music library
Comprehensive Second Opinion

Ask your health query to a doctor online

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.