GOLD Reports on Chronic Obstructive Pulmonary Disease (COPD): Evolutions, Revolutions and Controversies

Abstract

Twenty years after its start, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) continues to evolve and remains a source of progress and controversy in the area of chronic obstructive pulmonary disease (COPD) management. Major changes in the definition have occurred, influenced by progress in our understanding of the natural history of COPD. Similarly, while few new beneficial pharmacological classes have been developed, the way available medications should be used has significantly evolved. The burden of comorbidities is now well recognised, COPD being most often part of a multimorbid chronic condition. The role of non-pharmacological approaches has increased with a growing interest in complex interventions such as "integrated care" or "disease management". Instrumental support/interventions have also been an area of progress with new encouraging data on long-term non-invasive ventilation or endoscopic interventions. Altogether, COPD research is increasingly dynamic, and will most certainly solve future current debates and uncertainties. (BRN Rev. 2019;5(2):104-119)