chronic obstructive pulmonary disease; guidelines; inhaled corticosteroids; long acting beta agonist; long acting muscarinic antagonist; therapy
Abstract :
[en] BACKGROUND: Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. OBJECTIVES: To evaluate the level of medical experts' consensus on their preferred first-choice treatment within different COPD categories. METHODS: A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts. RESULTS: Good consensus was reached by both expert groups for long-acting bronchodilators instead of short-acting bronchodilators as first-choice treatment in GOLD A. Single bronchodilation with long-acting muscarinic antagonist (LAMA) was preferred over long-acting beta2-agonist (LABA) and LABA/LAMA as first-choice treatment in GOLD B and GOLD C. For GOLD D patients based on the forced expiratory volume in 1 second (FEV1)<50%, a very good consensus was reached for LAMA/LABA as first-choice treatment. For GOLD D patients based on frequent or severe exacerbations, there was a good consensus for LABA/LAMA/inhaled corticosteroids (ICS) as first choice in the Belgian group. According to the European experts, both LABA/LAMA and LABA/LAMA/ICS could be the first choice for these patients. CONCLUSION: Belgian and European experts recommend long-acting bronchodilators as first-choice treatment. Treatment containing ICS was found only appropriate in patients with FEV1<50% and >/=2 moderate exacerbations or 1 severe exacerbation/year.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Ninane, Vincent
Corhay, Jean-Louis ; Université de Liège > Département des sciences cliniques > Département des sciences cliniques
Germonpre, Paul
Janssens, Wim
Joos, Guy F.
Liistro, Giuseppe
Vincken, Walter
Gurdain, Sandra
Vanvlasselaer, Evelyne
Lehouck, An
Language :
English
Title :
Inhaled treatment of COPD : a Delphi consensus statement.
Publication date :
06 March 2017
Journal title :
International Journal of Chronic Obstructive Pulmonary Disease
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