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Data analysis of numerous studies was carried out and trends and directions in the management of patients 
with сhronic obstructive pulmonary disease (COPD) were analysed. Studying the characteristics of factors 
contributing to disease development без коми allows us to understand that the smoking epidemic, the aging of 
the world population and the lack of disease-modifying therapy will lead to a further increase in mortality from 
COPD. Each COPD exacerbation increases both the risk and frequency of subsequent exacerbations, and the 
development of local or systemic changes and complications has also been established. Not only severe but also 
moderate COPD exacerbations (those that do not require hospitalization and could be treated on an outpatient 
basis) also increased the risk of subsequent exacerbations and death. The degree of increase in risk was propor-
tional to the number of exacerbations per year. Thus, two moderate exacerbations per year increased the risk of 
death by 80 % (hazard ratio — 1.80 (95 % confidence interval (CI): 1.19—2.70)), while increased frequency of 
exacerbations to 5 increased the hazard ratio to 2.33 (95 % CI: 1.45—3.76).
The effectiveness of the treatment of patients with COPD and the dependence of the latter on various factors 
were evaluated. Based on the received data, the specialists have concluded that the presence of one severe or 
two or more moderate COPD exacerbations during one year indicates a high risk of exacerbations in the future 
and is associated with an increased risk of premature death. Therefore, a high-risk group patient requires special 
attention when choosing the tactics of his management. This is reflected both in international and national 
consensus documents. A single-inhaler triple therapy (specifically a fixed combination of budesonide/glycopyr-
ronium/formoterol), administered within the first 30 days after an exacerbation, is currently the only pharma-
cotherapeutic option that has been proven to reduce mortality in COPD patients.
Keywords 
Сhronic obstructive pulmonary disease, modifying factors of exacerbations, effective three-component therapy, 
mortality prevention.