Inhaled treatment of COPD: a Delphi consensus statement.
Int J Chron Obstruct Pulmon Dis
; 12: 793-801, 2017.
Article
em En
| MEDLINE
| ID: mdl-28293106
ABSTRACT
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 ß2-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.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Broncodilatadores
/
Técnica Delphi
/
Corticosteroides
/
Antagonistas Muscarínicos
/
Doença Pulmonar Obstrutiva Crônica
/
Agonistas de Receptores Adrenérgicos beta 2
/
Pulmão
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Int J Chron Obstruct Pulmon Dis
Ano de publicação:
2017
Tipo de documento:
Article