Pharmacological treatment of COPD: the devil is always in the detail. Issue 4 (19th April 2018)

• Record Type: Journal Article
• Authors: Singh, Dave; Barnes, Peter J.; Stockley, Robert; Lopez Valera, Maria Victorina; Vogelmeier, Claus; Agusti, Alvar
• Is Part Of: European respiratory journal. Volume 51:Issue 4(2018)
• Publication Date: 2018-04-19
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00263-2018
• Languages: English
• ISSNs: 0903-1936

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition with considerable pathophysiological and clinical variability across patients [1]. For this reason, the current Global Initiative for the Management of Chronic Obstructive Lung Disease (GOLD) report recommends an individualised treatment approach for patients with a diagnosis of COPD that has been established by appropriate clinical and spirometric criteria [2]. This approach is based on symptom severity and exacerbation history (which predicts future exacerbation risk) [2], and categorises patients into four "phenotypic" groups (A, B, C or D) [2, 3]. Each group has distinct pharmacological treatment algorithms where the clinical response to treatment (improvement, no change or deterioration) is used to escalate, de-escalate or switch treatment. It is straightforward in treatment-naïve individuals seen at initial presentation by healthcare workers but it may become more complex and cumbersome during follow-up . GOLD ABCD should be used for initial assessment and treatment, but follow-up treatment should focus on treatable traits http://ow.ly/Vm5l30iXYYU