Personalized medicine in COPD treatment

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, and not all patients respond to all currently available drugs. The importance of personalized treatment of COPD is increasingly recognized. The new GOLD guidelines have moved the principles of treatment of stable COPD forward by including concepts of symptoms and risks into the decision for therapy. COPD phenotypes are the basis of personalized treatment in clinical practice. Consensus has been reached concerning several phenotypes: phenotypes according to the evaluation of image; the frequent exacerbator and infrequent exacerbator; asthma and COPD overlap syndrome; and the persistent systemic inflammation phenotype. These phenotypes can help clinicians identify patients that respond to specific pharmacological interventions. Comorbidities and other factors, such as social and economic status, must also be considered. Future research needs to validate potential phenotypes in longitudinal studies, and examine the responses of different phenotypes to existing and future therapies.