title: Pharmacological treatment of chronic obstructive pulmonary disease: from evidence-based medicine to phenotyping.
abstract: Chronic obstructive pulmonary disease (COPD) is characterized by large phenotype variability, reflected by a highly variable response to pharmacological treatment. Nevertheless, current guidelines suggest that patients with COPD of similar severity should be treated in the same way. The phenotype-based pharmacotherapeutic approach proposes bronchodilators alone in the nonfrequent exacerbator phenotype and a combination of bronchodilators and inhaled corticosteroids in patients with asthma-COPD overlap syndrome (ACOS) and moderate-to-severe exacerbator phenotype. The clinical importance of phenotypes is changing the paradigm of COPD management from evidence-based to personalized medicine. However, the personalized pharmacological strategy of COPD has to be validated in future clinical studies.
authors.affiliation: Department of Pharmacology, Faculty of Medicine, University Hospital Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: pmontuschi@rm.unicatt.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Montuschi
authors.affiliation: Department of Internal Medicine, Spedali Civili di Brescia, University of Brescia, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Malerba
authors.affiliation: Department of Pharmacology, Faculty of Medicine, University Hospital Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santini
authors.affiliation: Pneumology Department, Hospital Universitari Vall d'Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
mesh_terms: D000818:Animals; D001249:Asthma / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology; D019317:Evidence-Based Medicine; D006801:Humans; D010641:Phenotype; D057285:Precision Medicine; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000188:drug therapy* / Q000453:epidemiology