title: Clinically relevant subgroups in COPD and asthma.
abstract: As knowledge of airways disease has grown, it has become apparent that neither chronic obstructive pulmonary disease (COPD) nor asthma is a simple, easily defined disease. In the past, treatment options for both diseases were limited; thus, there was less need to define subgroups. As treatment options have grown, so has our need to predict who will respond to new drugs. To date, identifying subgroups has been largely reported by detailed clinical characterisation or differences in pathobiology. These subgroups are commonly called "phenotypes"; however, the problem of defining what constitutes a phenotype, whether this should include comorbid diseases and how to handle changes over time has led to the term being used loosely. In this review, we describe subgroups of COPD and asthma patients whose clinical characteristics we believe have therapeutic or major prognostic implications specific to the lung, and whether these subgroups are constant over time. Finally, we will discuss whether the subgroups we describe are common to both asthma and COPD, and give some examples of how treatment might be tailored in patients where the subgroup is clear, but the label of asthma or COPD is not.
authors.affiliation: Clinical and Experimental Medicine, University of Birmingham, Queen Elizabeth Hospital Birmingham, Birmingham, UK Dept of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK a.m.wood@bham.ac.uk.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Turner
authors.affiliation: Dept of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Lilla
authors.initials: L
authors.lastname: Tamasi
authors.affiliation: Respiratory Medicine, CHU Sart-Tilman B35, Liege, Belgium.
authors.forename: Florence
authors.initials: F
authors.lastname: Schleich
authors.affiliation: Service of Allergology and Clinical Immunology, UHC "Mother Teresa", Tirana, Albania.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Hoxha
authors.affiliation: Dept of Pulmonology, Semmelweis University, Budapest, Hungary.
authors.forename: Ildiko
authors.initials: I
authors.lastname: Horvath
authors.affiliation: Respiratory Medicine, CHU Sart-Tilman B35, Liege, Belgium.
authors.forename: Renaud
authors.initials: R
authors.lastname: Louis
authors.affiliation: GlaxoSmithKline, Stockley Park West, Uxbridge, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Barnes
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D015897:Comorbidity; D006801:Humans; D018579:Patient Selection; D010641:Phenotype; D011237:Predictive Value of Tests; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors