Can my asthma-COPD overlap syndrome get worse over time?

Question

Hello doctor,

I have been struggling with severe breathing problems for a few years. My doctor says I have an asthma-COPD overlap. I get breathless even when walking slowly, and I have had two hospital visits this year. I use inhalers, but they do not always help.

Is this condition likely to keep getting worse?
What else can I do beyond inhalers?
Are there advanced treatments or biologic injections available?
Could oxygen therapy or pulmonary rehabilitation improve my quality of life?

Please advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns, and it is completely valid to feel overwhelmed.

Asthma-COPD (chronic obstructive pulmonary disease) overlap is a challenging condition, but there are effective ways to manage symptoms and improve your quality of life.

Your two hospitalizations this year suggest that your current treatment plan may need adjustment. It is important to work closely with your doctor to optimize your therapy. Treatment options include:

Biologic therapies (for the asthma component). If standard inhalers are not providing sufficient control, biologic medications such as Dupilumab (Dupixent), Omalizumab (Xolair), or Mepolizumab (Nucala) may help reduce flare-ups and improve lung function.
Low-dose Theophylline or Roflumilast (Daliresp), commonly used for COPD; these may be added if inhalers alone are insufficient. However, potential side effects should be carefully monitored.
If your blood oxygen saturation falls below 88 percent (confirmed via pulse oximetry or arterial blood gas testing), oxygen therapy can help relieve breathlessness and reduce strain on your heart.
Smoking cessation (if applicable) is absolutely essential. Nutrition and hydration can maintain muscle strength and avoid excessive carbohydrates, which can increase carbon dioxide levels.

Follow up with a specialist pulmonologist to reassess your condition and explore these treatment options in detail.

I hope this helps you.

Thank you.