TABLE 1

Subgroups of chronic obstructive pulmonary disease (COPD) that currently have specific treatments

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.