Advances in Pharmacological Management of Asthma and COPD:Integrating Pathophysiology with Emerging Therapies

Introduction: This review provides a comprehensive analysis of the pathophysiological mechanisms underlying asthma and COPD and explores the progress and innovations in pharmacological interventions, including traditional treatments, biologics, and novel drug delivery systems. Methods: The study was performed by a literature survey of original research articles published in PubMed, ScienceDirect, Web of Science, Scopus, and Google, using keywords such as “asthma”, “COPD”, “pathophysiology”, and “emerging treatments”. were used to identify peer-reviewed research, clinical guidelines, and clinical trial data published within the last decade. Results: Biologic therapies targeting IgE, IL-5, and IL-4/13 pathways have markedly improved asthma outcomes, particularly in eosinophilic phenotypes. In COPD, pharmacotherapy remains centred on bronchodilators, with advances including triple inhaler combinations, phosphodiesterase-4 inhibitors, and biomarker-guided treatment using blood eosinophil counts. Innovative inhalation devices such as soft-mist and smart inhalers enhance adherence and drug deposition. Discussion: Advances in molecular understanding have driven a shift from symptom-based to mechanism- targeted therapy. Asthma management has been revolutionised by biologics, while COPD therapy progresses more slowly due to complex inflammatory mechanisms and limited targeted options. Integration of biomarkers like eosinophils and FeNO supports precision-based care, though high cost, limited access, and adherence challenges persist. The emergence of digital health platforms and smart inhalers offers promising avenues for personal disease monitoring and control. Conclusion: Pharmacological management of asthma and COPD is transitioning toward personalised and precision medicine. Integrating clinical biomarkers, digital health tools, and next-generation biologics will be vital for improving long-term disease control, reducing exacerbations, and enhancing patient quality of life.