TABLE 1.
Subgroup | Treatment | Effect of treatment | [Ref.] |
Frequent exacerbator | LABA, LAMA, LABA/ICS, roflumilast, macrolides | Reduced exacerbations, better HRQoL, improved lung function, possible effect on FEV1 decline¶ and mortality¶ | [4–11] |
Chronic bronchitis | Roflumilast, mucolytics | Reduced exacerbations, improved HRQoL | [12–14] |
α1-antitrypsin deficiency | α1-antitrypsin augmentation | Reduced progression of emphysema | [15] |
Upper zone dominant emphysema and bullous emphysema | LVRS | Improved lung function, reduced exacerbations | [16, 17] |
Type 1 respiratory failure | LTOT | Improved survival and HRQoL | [18, 19] |
Type 2 respiratory failure | Domiciliary NIV | Improved survival, possible effect on hospital admissions and HRQoL | [20–24] |
Eosinophilic COPD# | Steroids | Reduced exacerbations, improved lung function | [25–27] |
Biomass COPD | Removal of biomass exposure | Reduced FEV1 decline | [28] |
Frequent exacerbator, chronic bronchitis and α1-antitrypsin deficiency are stable over time; the other subgroups may vary according to disease severity or evidence is not yet clear. LABA: long-acting β-agonists; LAMA long-acting muscarinic antagonists; ICS: inhaled corticosteroids; HRQoL; health-related quality of life; FEV1: forced expiratory volume in 1 s; LVRS: lung volume reduction surgery; LTOT: long-term oxygen therapy; NIV: noninvasive ventilation. #: see “Subgroups shared between COPD and asthma” section; ¶: effect only reported for LABA/ICS.