Evolution of definitions, classification, and treatment in chronic obstructive pulmonary disease: A comparative review of GOLD reports and international guidelines

This review examines the evolution of chronic obstructive pulmonary disease (COPD) definitions, patient classification frameworks, and pharmacological treatment recommendations across international guidelines, with an emphasis on Global Initiative for Chronic Obstructive Lung Disease (GOLD) and national guidance.Historical and contemporary approaches to symptom assessment, exacerbation risk stratification, and spirometry are contrasted, and evidence is synthesized for bronchodilator-based initial therapy, escalation to dual and triple therapy, and selective inhaled corticosteroid use.Updates on biomarkers and treatable traits are appraised, areas of alignment and divergence among guideline bodies are discussed, and implications for individualized treatment planning and implementation in clinical practice are highlighted.Finally, evidence gaps and research priorities to support risk-based, outcomesdriven COPD care are defined.