Is ‘GOLD’ standard for the management of COPD in clinical practice?

Yawn, Barbara P.

doi:10.7573/dic.212243

Cited by 11 publications

(11 citation statements)

References 111 publications

(120 reference statements)

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“…According to the GOLD recommendations, the beneficial effects of methylxanthines on lung function and other clinical end points are modest and inconsistent [1] . Recent data showing the effects of methylxanthines on inflammation and fibrosis may account for the increased use of methylxanthines in the other European countries [19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Treatment of COPD Exacerbation in Switzerland: Results and Recommendations of the European COPD Audit

Buess

Schilter²,

Schneider³

et al. 2017

Respiration

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Background: The European COPD Audit initiated by the European Respiratory Society (ERS) evaluated the management of hospital admissions due to exacerbation of chronic obstructive pulmonary disease (COPD) in several European countries. Data on the treatment of severe acute exacerbations of COPD (AECOPDs) in Switzerland are scarce. Objectives: In light of the GOLD 2010 guidelines, this work aims to examine the quality of care for AECOPD and to provide specific recommendations for the management of severe AECOPD in Switzerland. Methods: A total of 295 patients requiring hospital admission to 19 Swiss hospitals due to exacerbation of COPD during a predefined 60 days in 2011 were included in the study. We compared the Swiss data to the official GOLD 2010 recommendations and to the results of the other European countries. Results: Approximately 43% of the Swiss patients with severe AECOPD were current smokers at hospital admission, compared to 33% of the patients in other European countries (p < 0.001). In Switzerland and in Europe, spirometry data were not available for most patients at hospital admission (65 and 60%, respectively; p = 0.08). In comparison to other European countries, antibiotics were prescribed 14% less often in Switzerland (p < 0.001). Only 79% of the patients in the Swiss cohort received treatment with a short-acting bronchodilator at admission. Conclusions: Considering the overall high standard of health care in Switzerland, in light of the GOLD 2010 guidelines we are able to make 7 recommendations to improve and standardize the management of severe AECOPD for patients treated in Switzerland.

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Section: Discussionmentioning

confidence: 99%

Treatment of COPD Exacerbation in Switzerland: Results and Recommendations of the European COPD Audit

Buess

Schilter²,

Schneider³

et al. 2017

Respiration

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“…LTRAs are known to be less effective than LABAs in treating COPD. 46 The effects of LTRA add-on treatment on asthma exacerbations were significantly different from those of LABA in the presence of COPD comorbidity. The probabilities of asthma exacerbations were not significantly different between the two add-on treatments in the absence of COPD, which might suggest that LTRA is more effective in controlling asthma in the absence than in the presence of COPD, but further research with a larger sample of older adults without COPD is required to confirm this effect.…”

Section: Discussionmentioning

confidence: 97%

“…The prevalence of COPD diagnosis in this sample of older adults with asthma was high (78%). LTRAs are known to be less effective than LABAs in treating COPD . The effects of LTRA add‐on treatment on asthma exacerbations were significantly different from those of LABA in the presence of COPD comorbidity.…”

Section: Discussionmentioning

confidence: 98%

Antileukotriene Agents Versus Long‐Acting Beta‐Agonists in Older Adults with Persistent Asthma: A Comparison of Add‐On Therapies

Altawalbeh

Thorpe

Zgibor

et al. 2016

J American Geriatrics Society

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“…Despite the fact that COPD affects the lungs, it can refer to the function of the whole body (multi-organ abnormalities: cardiac disease, osteoporosis, skeletal disorders, neurological impairment and systemic inflammation). According to the gold standard, diagnosis of COPD should be based on evaluation of the clinical history of the patients and results of pulmonary function tests (PFTs) [ 3 ]. The disease is characterized by progressive and non-fully reversible airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…This is most commonly associated with an abnormal inflammatory response of the respiratory system to harmful dust and substances. The main exogenous risk factor of COPD is cigarette smoking (about 80% of cases) [ 1 – 3 ]. However, in the population of long-term smokers, only 20% develop COPD, which indicates that some other factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

Impact of I/D polymorphism of ACE gene on risk of development and course of chronic obstructive pulmonary disease

Mlak¹,

Homa‐Mlak²,

Powrózek³

et al. 2016

aoms

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IntroductionChronic obstructive pulmonary disease (COPD) affects more than 10% of the world's population over 40 years of age. The main exogenous risk factor is cigarette smoking; however, only 20% of smokers develop COPD, indicating that some other factors, e.g. genetic, may play an important role in the disease pathogenesis. Recent research indicates that ACE (angiotensin-converting enzyme) may be a susceptibility gene for asthma or COPD. The aim of our study was to determine the influence of I/D (insertion/deletion) polymorphism of the ACE gene (AluYa5, rs4646994) on the risk and course of COPD.Material and methodsWe investigated ACE I/D polymorphism in 206 COPD and 165 healthy Caucasian subjects.ResultsIn the generalized linear model (GLZ) analysis of the influence of selected factors on presence of COPD we found a significant independent effect for male sex (repeatedly increases the risk of COPD, OR = 7.7, p = 0.049), as well as smoking or lower body mass index, but only in combination with older age (OR = 0.96, p = 0.003 and OR = 1.005, p = 0.04 respectively). Interestingly, analysis of factors which may influence the risk of a higher number of exacerbations demonstrated that occurrence of DD genotype, but only in men, is associated with a lower risk (OR = 0.7, p = 0.03) of this complication.ConclusionsWe suggest that ACE may not be a susceptibility gene for the origin of COPD but a disease-modifying gene. Since the impact of I/D polymorphism of the ACE gene on COPD risk is moderate or negligible, other molecular changes, that will help predict the development of this disease, should still be sought.

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Is ‘GOLD’ standard for the management of COPD in clinical practice?

Cited by 11 publications

References 111 publications

Treatment of COPD Exacerbation in Switzerland: Results and Recommendations of the European COPD Audit

Treatment of COPD Exacerbation in Switzerland: Results and Recommendations of the European COPD Audit

Antileukotriene Agents Versus Long‐Acting Beta‐Agonists in Older Adults with Persistent Asthma: A Comparison of Add‐On Therapies

Impact of I/D polymorphism of ACE gene on risk of development and course of chronic obstructive pulmonary disease

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