A recent single-center study reviewed six cases of allergic bronchopulmonary aspergillosis (ABPA) in patients with underlying COPD, detailing their clinical features and treatment outcomes over 1–4 years.

Why It Matters To Your Practice

• ABPA is underrecognized in COPD, but overlaps may explain persistent or atypical symptoms.

• Early identification enables targeted management, potentially altering disease trajectory.

• Misdiagnosis risks unnecessary treatments or missed opportunities for intervention.

• Awareness can prompt appropriate workup in high-risk COPD populations.

Clinical Benefits

• Corticosteroids led to good disease control in most cases.

• Biologics (omalizumab) provided options for steroid-refractory patients.

• Stable disease achieved in two-thirds of patients followed long-term.

• ABPA represents a treatable trait in select COPD patients.

Managing Risks

• Monitor for steroid-related adverse effects, especially in older adults.

• Biologic use requires careful patient selection and monitoring.

• Bronchiectasis and high eosinophil counts may increase exacerbation risk.

• Close follow-up is needed due to potential for recurrent exacerbations or organ failure.

The Bottom Line

• Consider ABPA in COPD patients with persistent symptoms, eosinophilia, or bronchiectasis.

• First-line therapy is corticosteroids; biologics are an option for refractory cases.

• Early recognition and treatment can improve outcomes but require vigilance for complications.

• Balance benefits and risks through individualized, evidence-based care.