Global Initiative for Chronic Obstructive Lung Disease (GOLD) Revisions 2001-2017: Historical and Critical Perspective

Vogelmeier, Claus; Criner, Gerard J.; Martínez, Fernando J.

doi:10.23866/brnrev:2017-m0046

Cited by 5 publications

(6 citation statements)

References 24 publications

(25 reference statements)

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“…This method (Vitalograph Pneumotrac 77000PC based spirometry, England) was performed by an experienced operator to characterize disease progression and classify the COPD patients by severity based on the forced expiratory volume in 1 second (FEV1). Accordingly, FEV1 values ≥80%, 50%≤ FEV1< 80%, 30% ≤ FEV1 <50%, and FEV1 < 30% were considered as mild, moderate, severe and very severe intensity, respectively ( 12 ). The protocol of this process was first fully explained to the patient; then, spirometry test was performed for each patient.…”

Section: Methodsmentioning

confidence: 99%

Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease

Ahmadi

Mazloom

Eftekhari

et al. 2021

mjiri

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Background: Chronic obstructive pulmonary disease (COPD), as an airway limitation condition, is accompanied by alteration of muscle mass and function. We aimed to determine the relationship between disease severity and body composition, muscle function, and nutritional status in COPD patients. Methods: This cross-sectional study was conducted on 129 COPD participants. Muscle strength, body composition, and calf circumference (CC) were measured using a hydraulic hand dynamometer, bioelectrical impedance analysis (BIA), and a tape measure, respectively. Furthermore, fat-free mass index (FFMI), body mass index (BMI) and muscle mass value were calculated by equations. Forced expiratory volume in one second (FEV1) was assessed as well. Nutritional status was also evaluated by subjective global assessment (SGA) questionnaire. SPSS software (version 21 ) was used, chi-square, fisher’s exact test, univariate and multivariate linear regression models were used for statistical analysis. P-values less than 0.05 were considered significant. Results: Based on FEV1 classification, 52.7% of the patients had severe conditions. The reports indicated that the prevalence of low CC was 54.2%, low muscle mass 38.7%, low FFMI 34.8%, low right handgrip strength 61.2% and low left handgrip strength 64.3%. Furthermore, there was an increasing trend based on FEV1 in low CC (p=0.032), low muscle mass (p=0.005), low FFMI (p=0.002), low right handgrip strength (p=0.004) and low left handgrip strength (p=0.014). The results of univariate analysis showed muscle mass (p=0.036), total protein (p=0.043), FFM (p=0.047), FFMI (p=0.007), SGA (p=0.029), right handgrip strength (p=0.004) and left hand grip strength (p=0.023) were associated with FEV1. In addition, the results of multivariate analysis demonstrated low values of FFMI (p=0.005) and right handgrip strength (p=0.042) were the main detrimental factors for FEV1. The results of multivariate analysis were confirmed by stepwise model. Conclusion: Low values of muscle mass and function are prevalent among COPD patients. The present study revealed that low FFMI and handgrip strength were closely related to disease severity.

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Section: Methodsmentioning

confidence: 99%

Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease

Ahmadi

Mazloom

Eftekhari

et al. 2021

mjiri

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“…Vor diesem Hintergrund wurde unter der Schirmherrschaft des "National Heart, Lung and Blood Institute" der USA und der Weltgesundheitsorganisation (WHO) die "Global Initiative for Chronic Obstructive Lung Disease" (GOLD) gegründet. Dabei handelt es sich um eine Gruppe von Wissenschaftlern, die die Ziele hatten, die Aufmerksamkeit für die COPD zu steigern und ihre Prävention, Diagnostik und Therapie zu verbessern [2]. 2001 wurde der erste GOLD-Report veröffentlicht [3].…”

Section: Stand Der Dingeunclassified

COPD – was hat sich in GOLD 2023 geändert und ist für den Praxisalltag relevant?

Klemmer

Alter

Vogelmeier

2023

Dtsch Med Wochenschr

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Was ist neu? Diagnostik und Einschätzung des Schweregrads: Eine Diagnosestellung erfordert den spirometrischen Nachweis einer nachweisbaren obstruktiven Ventilationsstörung. GOLD empfiehlt weiterhin das FEV1/FVC-Verhältnis von <0,7 als Kriterium. In der deutschsprachigen COPD-Leitlinie sowie der NVL COPD ist die Möglichkeit aufgeführt, eine COPD zu diagnostizieren, wenn keine Obstruktion nachweisbar ist. Zur Einschätzung des Schweregrades hat GOLD das ABCD-Schema zum ABE-Schema verändert und fasst damit die Gruppen C und D zur Gruppe E (E=Exazerbationen) zusammen, um deren klinische Relevanz unabhängig von der sonstigen klinischen Symptomatik des Patienten zu betonen. Pharmakologische Therapie: Die Initialtherapie erfolgt nach dem ABE-Scheme. GOLD legt besonderen Wert auf die Auswahl des richtigen Inhalationssystems. Für die Follow-up-Situation ist entscheidend, ob die Patienten nur unter Symptomen leiden oder zwischenzeitlich unter Therapie auch Exazerbationen aufgetreten sind. Therapie und Auswirkung auf die Mortalität: Eine Reihe von nicht medikamentösen Therapiemaßnahmen hat signifikante Auswirkungen auf die Mortalität: diese reichen von Rauchentwöhnung über Rehabilitation, Langzeitsauerstofftherapie und nicht invasive Beatmung bis zur Lungenvolumenreduktion. Die Behandlung mit Triple-Therapien kann bei Patienten, die unter Therapie Exazerbationen entwickeln, einen signifikanten Überlebensvorteil im Vergleich zu LABA und LAMA bedingen. Exazerbationen GOLD schlägt eine neue Definition von COPD vor, die Symptome, Zeitverlauf, klinische Zeichen und Ursachen beinhaltet. Noch bedeutsamer ist aber die empfohlene Einteilung des Schweregrades, der jetzt auch darauf abhebt, dass wichtige Differenzialdiagnosen (insbesondere Herzinsuffizienz, Pneumonie, Lungenembolie) ausgeschlossen werden.

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“…Since inception, GOLD strived to provide updated information on management and prevention of COPD [ 6 ]. The first GOLD report was published in 2001 and has undergone major revisions and multiple smaller annual updates [ 7 ]. In the latest 2023 report, GOLD updated the definitions of COPD, exacerbations, taxonomy, disease assessment, and classification [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Delphi Consensus on Clinical Applications of GOLD 2023 Recommendations in COPD Management: How Aligned are Recommendations with Clinical Practice?

Anzueto,

Cohen,

Echazarreta

et al. 2023

Pulm Ther

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Introduction The objective of this Delphi study was to understand and assess the level of consensus among respiratory experts on the clinical application of GOLD 2023 recommendations in management of patients with chronic obstructive pulmonary disease (COPD). Methods The study comprised two online surveys and a participant meeting with 34 respiratory experts from 16 countries. Responses of 73 questions were recorded using a Likert scale ranging from 0 (disagreement) to 9 (agreement). The consensus threshold was 75%. Results Survey 1 and survey 2 had 34 and 32 participants, respectively; and 25 attended the participant meeting. Consensus was reached on survey 1: 28/42; survey 2: 18/30 close-ended questions. A consensus was reached on the clinical relevance of most updates in definitions and diagnosis of COPD. Mixed results for the treatment recommendations by GOLD were noted: 74% agreed with the recommendation to initiate treatment with dual bronchodilators for group E patients; 63% agreed for including inhaled corticosteroids (ICS)/long-acting β 2 agonist(LABA)/ Long-acting muscarinic receptor antagonists (LAMA) as a treatment option for GOLD B patients. Also, consensus lacked on removing ICS + LABA as an initial therapeutic option, in countries with challenges in access to other treatment option;. 88% agreed that they use GOLD recommendations in their daily clinical practice. Conclusions This Delphi study demonstrated a high level of consensus regarding key concepts of GOLD 2023 report, with most participants favoring recent updates in definitions, diagnosis, management, and prevention of COPD. More evidence on the etiotype based management and treatment options for group B and E are required which could further strengthen clinical application of the GOLD report. Supplementary Information The online version contains supplementary material available at 10.1007/s41030-023-00248-6.

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Global Initiative for Chronic Obstructive Lung Disease (GOLD) Revisions 2001-2017: Historical and Critical Perspective

Cited by 5 publications

References 24 publications

Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease

Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease

COPD – was hat sich in GOLD 2023 geändert und ist für den Praxisalltag relevant?

Delphi Consensus on Clinical Applications of GOLD 2023 Recommendations in COPD Management: How Aligned are Recommendations with Clinical Practice?

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