Abstract
Chronic obstructive disease is a serious respiratory condition affecting at least one fifth of the senior population in Europe. The level to which individual patients are affected can greatly differ.
The various forms are referred to as phenotypes. Every phenotype is described by a set of clinical finding, functional changes and results of imaging and laboratory examinations.
At present, specific therapeutic options exist, targeted at individual phenotypes. Patients who simultaneously suffer from bronchial asthma or repeated exacerbations as well profit from a treatment by inhalation corticosteroids and long acting inhaled beta agonist.
In cases where bronchial phenotype is expressed, roflumilast is recommended to be administered to such patients. In cases of emphysema, either surgical treatment can be applied or bronchoscopic techniques, both aimed at reducing the volume of the lungs.
Patients with prominent bronchioctases can benefit from antibiotics, mucoactive drugs and special physiotherapeutic procedures. Pulmonary cachexia can be acted against using physiotherapy and nutritional support.
Phenotype-targeting treatment is already a part therapeutic recommendations in some countries, most prominently in the Czech Republic and in Spain.