A 62-year-old man with COPD has CAT score 22, mMRC dyspnea scale 3, post-bronchodilator FEV1 38% predicted, and 3 exacerbations in the past year. According to GOLD 2023, what is his GOLD classification group and the preferred initial maintenance therapy?
- A GOLD Group E — LABA + LAMA + ICS triple therapy ✓
- B GOLD Group D — LABA + LAMA + ICS triple therapy
- C GOLD Group C — LABA monotherapy
- D GOLD Group D — LABA + LAMA dual therapy
Correct answer: A. GOLD Group E — LABA + LAMA + ICS triple therapy
Explanation
GOLD 2023 revised classification abandoned ABCD groups in favour of ABE groups: Group E (Exacerbator) replaces old Groups C and D. With ≥2 moderate exacerbations or ≥1 hospitalisation, elevated symptoms (CAT ≥10 or mMRC ≥2), and severe airflow limitation, this patient is classified as GOLD Group E. For Group E, triple therapy (LABA + LAMA + ICS) is recommended as initial pharmacological treatment, particularly if blood eosinophils ≥300 cells/μL, per GOLD 2023 report.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.