Management of stable COPD

• management strategy of stable COPD should be predominantly based on the assessment of symptoms and future risk of exacerbations
• all individuals who smoke should be strongly encouraged and supported to quit
• main treatment goals are reduction of symptoms and future risk of exacerbations
• management strategies include pharmacological and non-pharmacological interventions.

Management of COPD is summarized in the 2025 GOLD report (1)

Notes:

• a major differential diagnosis is asthma. In some patients with chronic asthma, a clear distinction from COPD is not possible using current imaging and physiological testing techniques. In these patients, current management is similar to that of asthma
• Alpha-1 antitrypsin deficiency (AATD) screening:
  • the World Health Organization recommends that all patients with a diagnosis of COPD should be screened once especially in areas with high AATD prevalence
    • a low concentration (< 20% normal) is highly suggestive of homozygous deficiency
      • family members should also be screened

Reference:

1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2025 report. 2025 [internet publication].