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Can newer treatments help manage 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, and I smoked for about ten years in my twenties. I was diagnosed with asthma years ago, but now they say it is more like “overlap” with chronic obstructive pulmonary disease. I am on triple therapy inhaler (inhaled corticosteroid, long-acting beta agonist, long-acting muscarinic antagonist), but still have flare-ups if I catch a cold or if the weather changes. I also get short of breath walking up stairs. I have read about Dupilumab and Tezepelumab, and I am trying to quit vaping completely, but it is tough. I am scared this might keep getting worse, no matter what I do.

  • Are there newer biologic treatments that help people like me?

  • Would Dupilumab and Tezepelumab apply here?

  • Does pulmonary rehabilitation really help breathing or only exercise tolerance?

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.

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Hello,

Welcome to icliniq.com.

I understand your concern.

You are describing the typical asthma-COPD (chronic obstructive pulmonary disease) overlap picture I see often. First, let us confirm the overlap and your current control. I would recommend you do spirometry with a bronchodilator and get your inhaler technique reviewed. Then get blood eosinophils, fractional exhaled nitric oxide, total immunoglobulin E, and allergy testing. These numbers tell us if there is an allergic component, and if so, which one. Also, if total immunoglobulin E is high and if symptoms suggest those like yours, then you should also get a serum Aspergillus-specific immunoglobulin E test done to rule out allergic bronchopulmonary aspergillosis (ABPA).

Biologic treatments can help people with asthma-chronic obstructive pulmonary disease overlap when the asthma biology is active despite high-dose inhaled corticosteroid, long-acting beta agonist, and long-acting muscarinic antagonist. Depending upon your test results, the best-suited biological treatment is prescribed.

Before or alongside biologic treatments, I make sure the foundations are flawless. We meticulously correct inhaler technique and confirm you are truly on high-dose inhaled corticosteroid as part of triple therapy. Some patients benefit from switching their reliever (as needed) to Budesonide-Formoterol to treat the flare at the first cough.

Vaccines such as influenza, pneumococcal, and coronavirus disease boosters, and aggressive treatment of sinus disease, gastroesophageal reflux disease, and obstructive sleep apnea are significant game changers because they remove common flare triggers.

Pulmonary rehabilitation helps more than just exercise tolerance. Done well, it can be life-changing, and one can benefit a lot.

For vaping cessation, the most effective path is a combined plan: set a quit date, remove triggers, and use medication support. Try nicotine replacement such as a patch or short-acting gum, or lozenge, and if still no help, there are some drugs from which you may benefit, such as Varenicline. Smoking or vaping cessation can benefit extremely well.

Consider a low-dose computed tomography if exacerbations continue to rule out bronchiectasis or other contributors.

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 8, 2026
Reviewed At January 13, 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.

Consult other doctors in the same speciality

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Dr. Amandeep Singh Arneja
Dr. Amandeep Singh Arneja

Pulmonology (Asthma Doctors)

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.

Consult other doctors in the same speciality
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