Treatment of COPD with FEV1 ≥ 50% and Mild Dyspnoea (mMRC 0–1) with Persistent Symptoms

This protocol addresses the low-risk COPD patient whose lung function is relatively preserved but who continues to experience respiratory symptoms that interfere with daily activities.

Clinical scenario

Patients in this category have FEV1 ≥ 50%, a dyspnoea score of mMRC 0 or 1, and one or no exacerbations in the previous year (none requiring hospitalisation). Despite this low-risk profile, they present with permanent respiratory symptoms that limit daily tasks.

Treatment approach

The pharmacological approach centres on a specific class of bronchodilator combination therapy.
The complete regimen — including preferred agents, sequencing, and any escalation criteria — is detailed in the full structured protocol.

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References

DOI: 10.3390/jcm13020303

"Low risk" are those with FEV1 ≥ 50%, dyspnoea (mMRC) of 0 or 1 and one or no exacerbation in the previous year (without hospitalisation).

In the low-risk patient with permanent respiratory symptoms or those that limit daily tasks, the basis of pharmacological treatment should be LAB, preferably LAMA over LABA.

For low-risk patients with inadequate control, dual bronchodilation therapy is advised.

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