[Outline of JRS COPD guideline Ed. 4]

JRS COPD guideline Edition 4 updated current concept for clinical management of COPD in Japan. Minor but substantial changes were added to the definition and subtype of the disease. In pharmacological treatment, single use of LAMA or LABA is equally the first choice. If it is not enough, those combination are recommended. A-D classification that was presented in GOLD report 2011 was not adopted. In non-pharmacological treatment, pulmonary rehabilitation is steadily effective and essential. In terms of survival prognosis, at least, the concept of physical activity is important. Those improvement and maintenance were newly added to the objectives of the clinical management of COPD.