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COPD is a heterogeneous disease that presents many management challenges. This review presents an update on promising advances from research.
- Patients with chronic obstructive pulmonary disease (COPD) should be encouraged to maintain regular physical exercise, and referral to pulmonary rehabilitation is recommended.
- Inhaled corticosteroids should be reserved for patients with moderate to severe COPD to reduce exacerbations; and patients with a blood eosinophil count of 0.3 x 109/L or greater are most likely to benefit.
- Inhaled corticosteroids may be withdrawn safely in patients with COPD who do not have frequent exacerbations and have a blood eosinophil count of less than 0.3 x 109/L (excluding patients with an asthma overlap syndrome).
- Highly selected patients may be suitable for endobronchial valve placement or lung volume reduction surgery. Referral to a respiratory specialist and an expert centre is recommended.