Table 4.
Differential treatment of chronic obstructive pulmonary disease and asthma
| Treatment | COPD | Asthma |
|---|---|---|
| Smoking cessation | Recommended, as smoking accelerates decline of lung function | Recommended, as smoking exacerbates condition |
| Air pollution | Avoid | Avoid |
| Allergen | – | Avoid/Reduce |
| Influenza vaccination | Recommended | Recommended |
| ICS3,4,56 | Not first-line therapy, reserved for use in severe/very severe COPD in combination with long-acting bronchodilator | Preferred therapy for inflammation in persistent asthma |
| β-2 agonists | Short-acting for short-term therapy at any disease state; longacting β-2 agonists recommended in moderate and severe, if short-acting β-2 agonists not effective | Recommended with ICS, if asthma not well controlled with ICS alone |
| Anticholinergics | Short-acting and longacting anticholinergics are recommended for moderate to severe COPD | Can be an option if β-2 agonists not well tolerated, but variable responses; not indicated in the USA for asthma |
| Systemic steroids | Used for exacerbation treatment | Used in severe asthma, for exacerbation treatment |
| Theophylline | Bronchodilators preferred, due to potential side effects of theophylline | Considered after bronchodilators and ICSs, due to potential side effects of theophylline |
| Oxygen | In advanced cases of COPD, when oxygen saturation is 88% or lower | For exacerbation management |
Abbreviations: COPD, chronic obstructive pulmonary disease; ICS, inhaled corticosteroid.