Global initiative gold and national recommendations on the management of patients with chronic obstructive pulmonary disease (COPD): the place of double bronchodilation

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic, environmentally mediated disease manifested by broncho-obstructive syndrome, which is not completely reversible.The purpose of this review was to summarize the latest changes in the management of these patients, which occurred in international and domestic guidelines.Methods. The analysis of work on the problem of COPD, available in the E-Library and PubMed electronic libraries, was carried out.Results. The year 2019 was marked by the renewal of global GOLD initiatives and the implementation of national guidelines for the diagnosis and treatment of COPD in practice. The most significant provisions are the following: double long-acting bronchodilators are the main treatment for stable COPD; specific indications are needed for the administration of ICS and they are not universal in the treatment of COPD; not all double bronchodilators are the same – their evidence base is not yet equivalent. The analysis of real practice shows that the use of shortacting bronchodilators, ICS and triple therapy remains excessive.Conclusion. Understanding of COPD is improving, identifying the most vulnerable points, problems, the solution of which will make it possible to take new steps to improve the quality of life of these patients and reduce mortality.