Authors :
Pooja Pandey; Dr. Nitika Thakur; Dr. Rizu
Volume/Issue :
Volume 10 - 2025, Issue 8 - August
Google Scholar :
https://tinyurl.com/yc6bzfhe
Scribd :
https://tinyurl.com/2tpvyfx2
DOI :
https://doi.org/10.38124/ijisrt/25aug920
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Abstract :
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with
over 400 million people affected and more than 3 million deaths annually. Despite therapeutic progress, COPD continues to
impose a substantial health and economic burden. This systematic review synthesizes evidence published from 2018–2025
on pharmacological and non-pharmacological management strategies for stable COPD. Using PRISMA methodology, we
included randomized controlled trials (RCTs), systematic reviews, and clinical guidelines. Evidence indicates that triple
inhaled therapy (ICS/LAMA/LABA) reduces exacerbations and mortality compared to dual therapy, pulmonary
rehabilitation improves functional outcomes, and long-term oxygen and non-invasive ventilation (NIV) confer survival
benefits in selected patients. Adjunctive measures such as smoking cessation, vaccination, macrolide prophylaxis, and
roflumilast also reduce exacerbations in high-risk patients. These findings support a multidimensional approach, integrating
pharmacological, rehabilitative, and lifestyle interventions, guided by GOLD 2025 recommendations.
References :
- World Health Organization. (2023, March 16). Chronic obstructive pulmonary disease (COPD) fact sheet. WHO. World Health Organization
- World Health Organization. (2023, November 15). Smoking is the leading cause of chronic obstructive pulmonary disease. WHO. World Health Organization
- Li, X., et al. (2025). Mapping the global distribution, risk factors, and temporal trends of COPD incidence and mortality (1990–2021): Ecological analysis. BMC Medicine. BioMed Central
- Lipson, D. A., et al. (2018). Once-daily single-inhaler triple versus dual therapy in patients with COPD. New England Journal of Medicine, 378(18), 1671–1680. The New England Journal of Medicine+1
- Rabe, K. F., et al. (2020). Triple inhaled therapy at two glucocorticoid doses in moderate-to-very-severe COPD (ETHOS trial). New England Journal of Medicine, 383(14), e28.
- Lipson, D. A., et al. (2018). Once-daily single-inhaler triple versus dual therapy in COPD. NEJM, 378(18), 1671–1680. https://doi.org/10.1056/NEJMoa1713901
- Rabe, K. F., et al. (2020). Triple inhaled therapy at two glucocorticoid doses in COPD. NEJM, 383(1), 35–48. https://doi.org/10.1056/NEJMoa1916046
- Jacobs, S. S., et al. (2020). Home oxygen therapy for adults with chronic lung disease. Am J Respir Crit Care Med, 202(10), e121–e141. https://doi.org/10.1164/rccm.202009-3608ST
- Dretzke, J., et al. (2022). Home non-invasive ventilation in COPD: A systematic review. JAMA, 323(5), 455–465. https://doi.org/10.1001/jama.2019.22343
- Cox, N. S., et al. (2021). Telerehabilitation for chronic respiratory disease. Cochrane Database of Systematic Reviews, (1), CD013040. https://doi.org/10.1002/14651858.CD013040.pub2
- Nakamura, K., et al. (2023). Effectiveness and safety of long-term macrolide therapy in COPD. Respiratory Research, 24, 240. https://doi.org/10.1186/s12931-023-02406-4
- Global Initiative for Chronic Obstructive Lung Disease (GOLD). (2025). Global strategy for the diagnosis, management, and prevention of COPD. Retrieved from https://goldcopd.org
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with
over 400 million people affected and more than 3 million deaths annually. Despite therapeutic progress, COPD continues to
impose a substantial health and economic burden. This systematic review synthesizes evidence published from 2018–2025
on pharmacological and non-pharmacological management strategies for stable COPD. Using PRISMA methodology, we
included randomized controlled trials (RCTs), systematic reviews, and clinical guidelines. Evidence indicates that triple
inhaled therapy (ICS/LAMA/LABA) reduces exacerbations and mortality compared to dual therapy, pulmonary
rehabilitation improves functional outcomes, and long-term oxygen and non-invasive ventilation (NIV) confer survival
benefits in selected patients. Adjunctive measures such as smoking cessation, vaccination, macrolide prophylaxis, and
roflumilast also reduce exacerbations in high-risk patients. These findings support a multidimensional approach, integrating
pharmacological, rehabilitative, and lifestyle interventions, guided by GOLD 2025 recommendations.