Summary: COPD, as a disease that constitutes a significant health burden for the patient, to some extent still remains a disease that is difficult to treat. Patients with this disease experience a significant deterioration in overall efficiency and quality of life. COPD exacerbations are a direct threat to their lives. As a result, during many years of treatment of this disease, the clinician will often have to answer the question of whether it is required to intensify treatment in a certain state of the disease. It should be remembered that the clinical GOLD category should be defined in the initial phase of the treatment, and not necessarily assigned to the patient for the entire treatment period. As part of the followup visits in the course of the disease, treatment may and often should be modified. The article discusses clinical situations that may require treatment intensification or deescalation.