GOLD 2017: what change were made in global strategy of treatment of chronic obstructive pulmonary disease and why?

Abstract

In 1997, the International Expert group on chronic obstructive pulmonary disease (COPD) has come to decision to initiate the Global Initiative for COPD (GOLD). The first GOLD report was published in 2001 and provided the basis for many national programs for COPD diagnosis and management. Research data accumulated in the next decade allowed to perform complete revision of global strategy in 2011 (updated 2013), considering personalized approach to prognosis and treatment selection in an individual patient. At the end of2016, anew comprehensive reassessment of GOLD report was released. The ABCD assessment tool has been refined; the role of spirometry in COPD management has been updated. Regular assessment of inhaler technique to improve the disease control has been emphasized. New data on therapy with long-acting β2-agonists/long acting anticholinergic combinations and «triple therapy» have been added. Classification of severity of COPD exacerbations was provided and impact of concomitant diseases was stressed. The section on pulmonary rehabilitation has been amplified.