Therapeutic options recommended by GOLD*

2018 GOLD assessment tool balances grade number and letter to designate COPD severity1

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was launched in 1998 in collaboration with the National Heart, Lung, and Blood Institute; the National Institutes of Health, USA; and the World Health Organization. GOLD’s guidelines for COPD are shaped by committees made up of leading experts from around the world. Working with health care professionals and public health officials, GOLD seeks to raise awareness and improve prevention and treatment of COPD.1

The 2018 ABCD assessment tool

 

© 2018 Global Strategy for Diagnosis, Management and Prevention of COPD. All rights reserved. Use is by express license from the owner.

  • ABCD groups are derived exclusively from patient symptoms and history of exacerbations1
    • This grouping is focused on the patient’s individual parameters, allowing more precise treatment (pharmacotherapy) strategies
       
  • According to the assessment tool, patients should undergo spirometry to determine the severity of the airflow limitation. They should then use either mMRC to assess dyspnea or CAT for symptom assessment. Finally, the patient’s history of exacerbations, including prior hospitalizations, should be documented1

  • FEV1 remains an important parameter at the population level in the prediction of important clinical outcomes such as mortality and hospitalizations, prompting consideration of nonpharmacologic therapy such as lung volume reduction or lung transplantation1
    • When assessing individual patients, FEV1 loses precision and cannot be used alone to determine all therapeutic options

When assessing risk, choose the highest risk according to GOLD* group or exacerbation history.

CAT, COPD assessment test; FEV1, forced  expiratory volume in 1 second; FVC, forced vital capacity; GOLD, Global Initiative for Chronic Obstructive Lung Disease; mMRC, modified Medical Research Council.

 

COPD treatment strategies focus on long-acting bronchodilators (LABAs, LAMAs) and combination therapy for appropriate patients1

 

 

*GOLD does not endorse any specific treatments.

© 2018 Global Strategy for Diagnosis, Management and Prevention of COPD. All rights reserved. Use is by express license from the owner.

ICS, inhaled corticosteroid; LABA, long-acting beta2-adrenergic agonist; LAMA, long-acting muscarinic antagonist.

CAT is the intellectual property of GlaxoSmithKline. Not validated for US-based physicians.

 


 

Reference:

  1. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2018:1-123.