The perfect storm: when COPD meets bronchiectasis

Abstract

COPD and bronchiectasis (BE) are two major respiratory conditions characterised by the presence of chronic respiratory symptoms and an increased risk for future events and disability. In ERJ Open Research, CHEN et al. [ERJ Open Res 2025; 11: 00626-2024] apply the ROSE criteria to explore the prevalence and clinical impact of the COPD-BE association in two East Asian cohorts, shedding new light on a population that has been underrepresented in previous research. The study stands out for its comprehensive approach, combining a prospective and a large multicentre retrospective cohort, allowing for a robust validation of the ROSE criteria in this specific demographic. One of the key findings of the study is the high prevalence of the COPD-BE overlap, identified in 16.5% of the participants, with higher rates in the prospective cohort. These patients were predominantly older males with more severe respiratory symptoms, worse lung function and a greater reliance on inhalation therapies. Most notably, this group exhibited a significantly increased risk of exacerbations and hospitalisations compared to those with bronchiectasis alone or those without fixed airflow limitation. This reinforces the value of the ROSE criteria not only in identifying this overlap but also in stratifying patients based on their risk of poor clinical outcomes