Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report. GOLD Executive Summary

Abstract

This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 report focuses primarily on the revised and novel parts of the document. The most significant changes include: (1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; (2) for each of the groups A to D, escalation strategies for pharmacologic treatments are proposed; (3) the concept of deescalation of therapy is introduced in the treatment assessment scheme; (4) nonpharmacologic therapies are comprehensively presented; and (5) the importance of comorbid conditions in managing chronic obstructive pulmonary disease is reviewed

Is the Metronome-Paced Tachypnea Test (MPT) Ready for Clinical Use? Accuracy of the MPT in a Prospective and Clinical Study

“…Both groups consisted of mild-to-very-severe COPD patients (GOLD guidelines [13]). The baseline characteristics are presented as mean (standard deviation) in Table 1.…”

Endoscopic Lung Volume Reduction: An Expert Panel Recommendation – Update 2019

“…The national and international guidelines recommend [2] that all patients should be treated stage dependently with medical therapy that comprises short- and long-acting bronchodilators including anti-muscarinic drugs and beta agonists, inhaled corticosteroids, pulmonary rehabilitation, and smoking cessation. Selected cases may require prophylactic antibiotics, phosphodiesterase inhibitors, oral corticosteroids, domiciliary and ambulatory oxygen support, and, in the context of respiratory failure, non-invasive nasal ventilation.…”

“…Emphysema is a progressive, irreversible, and debilitating disease resulting from inflammation caused by the prolonged exposure to noxious inhaled agents. The most commonly accepted cause of emphysema is cigarette smoking, but genetic, occupational, and other environmental causes also account for up to 10% of the cases [2]. The alveolar destruction leads to impairment in gas exchange and in air trapping with an increase in residual volume (RV) and hyperinflation.…”

“…Since then, additional randomized controlled trials (RCTs) have been published that alter the treatment decisions previously outlined in the original 2016 Expert Panel Report. Based on this increasing level of evidence, the use of ELVR techniques has been adopted and incorporated into the 2017 COPD GOLD [2], updated in the GOLD Report 2019 [9], and the use of one-way endobronchial valves (EBVs) has been recommended by the UK/NICE as a standard-of-care therapy [10]. EBVs have recently obtained US/FDA approval.…”

The Ratio Serum Creatinine/Serum Cystatin C (a Surrogate Marker of Muscle Mass) as a Predictor of Hospitalization in Chronic Obstructive Pulmonary Disease Outpatients

“…At the enrollment in the study, COPD patients were divided into different categorical groups: (1) nonsymptomatic patients (COPD Assessment Test [CAT] score < 10) versus symptomatic patients (CAT score ≥10) [19], (2) nondyspneic patients (modified Medical Research Council dyspnea score [mMRC] < 2) versus dyspneic patients (mMRC ≥2) [20], (3) high risk of exacerbation patients (those with 2 or more exacerbations requiring treatment with antibiotics or systemic steroids or at least one hospital admission in the previous year) versus low risk of exacerbation patients [19], and (4) former smokers versus active smokers.…”