Management of Chronic Obstructive Pulmonary Disease: An Evidence-Based Synthesis of Recent Advances (2018–2025)

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with over 400 million people affected and more than 3 million deaths annually. Despite therapeutic progress, COPD continues to impose a substantial health and economic burden. This systematic review synthesizes evidence published from 2018–2025 on pharmacological and non-pharmacological management strategies for stable COPD. Using PRISMA methodology, we included randomized controlled trials (RCTs), systematic reviews, and clinical guidelines. Evidence indicates that triple inhaled therapy (ICS/LAMA/LABA) reduces exacerbations and mortality compared to dual therapy, pulmonary rehabilitation improves functional outcomes, and long-term oxygen and non-invasive ventilation (NIV) confer survival benefits in selected patients. Adjunctive measures such as smoking cessation, vaccination, macrolide prophylaxis, and roflumilast also reduce exacerbations in high-risk patients. These findings support a multidimensional approach, integrating pharmacological, rehabilitative, and lifestyle interventions, guided by GOLD 2025 recommendations.