Management of Chronic Obstructive Pulmonary Disease: An Evidence-Based Synthesis of Recent Advances (2018–2025)


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 :

  1. World Health Organization. (2023, March 16). Chronic obstructive pulmonary disease (COPD) fact sheet. WHO. World Health Organization
  2. World Health Organization. (2023, November 15). Smoking is the leading cause of chronic obstructive pulmonary disease. WHO. World Health Organization
  3. 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
  4. 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
  5. 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.
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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.

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Paper Submission Last Date
30 - November - 2025

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