GOLD COPD Classification
GOLD 2023 ABCD assessment tool for COPD combining symptom burden (CAT/mMRC) and exacerbation history to guide therapy.
Score interpretation
GOLD Group A: Low exacerbation risk, low symptom burden, mild-moderate airflow limitation.
→ Initial therapy: SABA or SAMA PRN. If symptoms persist: LAMA or LABA. Annual spirometry. Smoking cessation. Pulmonary rehabilitation if deconditioning.
GOLD Group B: Low exacerbation risk, high symptom burden.
→ Initial therapy: LAMA + LABA dual bronchodilator. Pulmonary rehabilitation. Annual influenza + pneumococcal vaccination. Consider ICS if eosinophils ≥ 300.
GOLD Group E (formerly C/D): High exacerbation risk. Significant morbidity and mortality risk.
→ Initial therapy: LAMA + LABA. Add ICS if eosinophils ≥ 100 + ≥1 exacerbation. Consider roflumilast (FEV₁ < 50%, chronic bronchitis phenotype). Pulmonary rehabilitation. Assess for long-term oxygen therapy (LTOT) if SpO₂ ≤ 88% at rest.
Interpretation bands for the GOLD COPD. Apply clinical judgement and local guidance.
References
- GOLD 2023 Global Strategy for Prevention, Diagnosis and Management of COPD. Global Initiative for Chronic Obstructive Lung Disease.
- NICE NG115. Chronic obstructive pulmonary disease in over 16s. 2019.
Related
Curated clinical cross-links plus same-class fallbacks.
- Fluticasone Furoate / Umeclidinium / Vilanterol · Triple Therapy ICS/LAMA/LABA — COPD
- Beclometasone / Formoterol / Glycopyrronium · Triple Therapy ICS/LABA/LAMA — COPD
- Indacaterol / Glycopyrronium · LABA/LAMA Dual Bronchodilator — COPD
- Azithromycin (COPD Exacerbation Prophylaxis) · Macrolide antibiotic (anti-inflammatory / prophylactic)
- Doxycycline (COPD Exacerbation / CAP) · Oral tetracycline antibiotic
- Co-amoxiclav 625mg (COPD Exacerbation / CAP) · Beta-lactam / Beta-lactamase inhibitor combination antibiotic
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.