What is the recommended first-line therapy for patients classified in COPD Group A?

In patients classified in COPD Group A, the recommended first-line therapy is a single bronchodilator. Group A patients typically have mild symptoms and a low risk of exacerbations, often characterized by a low mMRC dyspnea score and few exacerbations in the past year. The use of a single bronchodilator, which can be either a short-acting beta-agonist (SABA) or a long-acting beta-agonist (LABA), is effective in relieving symptoms and improving lung function. This approach is aligned with the recommendations from various guidelines, which suggest starting treatment with the least intensive option to manage symptoms and minimize potential side effects.

By initiating treatment with a single bronchodilator, clinicians can provide effective symptom relief while monitoring the patient's response and adjusting treatment if necessary. This strategy helps prevent overtreatment in a population of patients who may have a relatively stable condition with manageable symptoms.

Other options, such as dual therapy involving LABA and LAMA, inhaled corticosteroids, or systemic corticosteroids, are considered for patients with more severe disease or those who experience frequent exacerbations and are not suitable for initial management in Group A patients.