Inhalation Therapy for Stable COPD: 20 Years of GOLD Reports
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REVIEW
Inhalation Therapy for Stable COPD: 20 Years of GOLD Reports Paul D. Terry . Rajiv Dhand
Received: February 8, 2020 The Author(s) 2020
ABSTRACT The Global Initiative for Chronic Lung Disease (GOLD) was formed in the late 1990s to spread awareness of chronic obstructive pulmonary disease (COPD) as a major public health problem and facilitate its prevention and treatment. GOLD has since become internationally recognized for the development of evidence-based strategy documents, most notably the annual GOLD Reports, for COPD diagnosis, management, and prevention. The GOLD Reports incorporate the latest evidence and expert
consensus to guide the management and prevention of COPD on a global level. Since the first GOLD Report in 2001, profound innovations have taken place regarding inhaler device options, available pharmaceuticals, knowledge regarding effective dosages and potential side effects, and the various combinations of drugs used to relieve symptoms. Concomitantly, an evolution of expert opinion on how best to apply these innovations to the care of patients with COPD has also taken place, an evolution that is nowhere more detailed or definitive than in the 20 years of annual GOLD Reports. We summarize key features and trends in inhalation therapy for stable COPD in these Reports.
Keywords: COPD; GOLD reports; Inhalation therapy
Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11940423. P. D. Terry R. Dhand (&) Department of Medicine, Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, TN, USA e-mail: [email protected]; [email protected]
Adv Ther
Key Summary Points The Global Initiative for Chronic Lung Disease (GOLD) is internationally recognized for the development of evidence-based strategy documents, most notably the annual GOLD Reports The GOLD Reports incorporate the latest evidence and expert consensus to guide the management and prevention of COPD on a global level The 20 years during which GOLD published their annual Reports has been a period of remarkable innovation and refinement of inhalation therapy for COPD The GOLD Reports document profound evolutions in the armamentarium of inhaled drugs in all categories of inhalation devices; the use of long-acting, combination, and triple therapies; algorithms for initial and follow-up treatment; the acceptance of nebulizers in regular maintenance therapy; and the emphasis on inhalation device choice, technique, and adherence, all of which are designed to optimize outcomes in COPD management We summarize key features and trends in inhalation therapy for stable COPD in these Reports
INTRODUCTION The GOLD Expert Panel, a distinguished group of health professionals from the fields of respiratory medicine, epidemiology, socioeconomics, public health, and health education, reviewed existing COPD guidelines, as well as new information on pathogenic mechanisms of COPD as they developed a consensus document. Many recommendations will require additional
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