Abstract:

The GOLD 2026 report presents several significant updates in the diagnosis， treatment， management， and prevention of chronic obstructive pulmonary disease （COPD）. For the very first time， this report integrates the concept of “disease activity”， spotlighting low disease activity as a core treatment objective. In terms of exacerbation risk stratification， patients who have experienced one or more moderate-to-severe exacerbations in the past year are categorized as high-risk， underscoring the significance of early detection and intervention. Vaccination strategies have been revised as well： the lower age threshold for respiratory syncytial virus （RSV） vaccination has been lowered to 50 years， an mRNA vaccine option has been introduced， and the evidence backing influenza vaccination in high-risk populations has been reinforced. The section on biologics demonstrates their effectiveness through evidence-based charts， which support precision-targeted therapy. The chapter on comorbidity management introduces the multimorbidity （syndemics concept） and utilizes the 4Ms framework to comprehensively tackle cardiovascular， respiratory， psychiatric， and metabolic comorbidities， along with clear instructions on corresponding interventions. Moreover， the report officially incorporates artificial intelligence and telemedicine into the clinical workflow. Overall， these updates signify a transition in COPD management towards a more proactive， precise， and comprehensive approach， offering crucial guidance for individualized treatment and optimized long-term care. This article intends to systematically summarize the key updates in GOLD 2026 to inform clinical practice.

Key words: chronic obstructive pulmonary disease, disease activity, acute exacerbation, biologics, vaccination, comorbidity management