[Diagnosis and Treatment of COPD: A Guideline for Respiratory Specialists 2026]

This S2k guideline updates the recommendations for the diagnosis and treatment of chronic obstructive pulmonary disease (COPD) by respiratory specialists and complements the German National Disease Management Guideline (NVL) with specialist recommendations for diagnosis and treatment. The guideline is based on current scientific evidence and a structured interdisciplinary S2k consensus process involving numerous scientific societies. Major updates include recognition of COPD as a heterogeneous disease, with expanded recommendations on its etiopathogenesis, early detection, and contemporary diagnostic approaches, including biomarkers, thoracic computed tomography, and lung cancer screening, as well as updated risk stratification. Recommendations on smoking cessation, non-pharmacological management, and pharmacological treatment have been comprehensively revised. These include consistent use of dual bronchodilation, earlier implementation of inhaled triple therapy in appropriate patients, and consideration of emerging treatment options, including biologics. Additional updates address the management of comorbidities, interventional treatment of advanced emphysema, and inpatient management of acute COPD exacerbations. The guideline aims to support individualized, phenotype-oriented, and evidence-based care for patients with COPD.