GOLD Panel Issues New Recommendations on Managing COPD

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The Global Initiative for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease (GOLD) has updated its recommendations for managing chronic obstructive pulmonary disease (COPD). The report is published in the American Journal of Respiratory and Critical Care Medicine.

Some of the changes since the 2011 update include:

• Spirometric results should be considered separately from the ABCD grouping of patients based on symptoms and exacerbation risk. Forced expiratory volume in one second (FEV1) is limited in making treatment decisions on the individual level, the authors write.

• Specific strategies to escalate and de-escalate therapies are offered.

• Non-pharmacologic treatments are included, such as pulmonary rehabilitation, exercise training, oxygen therapy, vaccinations, palliative care, and interventional bronchoscopy and surgery.

• Comorbidities, which are common with COPD, should be recognized and treated, with a goal of simplifying treatment and minimizing polypharmacy.