April 14, 2020--Clinicians grappling with the pharmacologic management of COPD in patients complaining of exercise intolerance or dyspnea now have new guidance. The American Thoracic Society has published an official clinical practice guideline in which a panel of experts strongly recommended LABA/LAMA combination therapy over LABA or LAMA alone. The complete guideline detailing all the recommendations was posted online ahead of print in the American Journal of Respiratory and Critical Care Medicine .
Pharmacologic management of COPD is focused on improving patients' quality of life while reducing the frequency of exacerbations. In this new clinical practice guideline, an expert panel addressed six "emerging questions around COPD management that were not covered in the previous guideline published in 2011 ," noted Shawn Aaron, MD, co-chair of the guideline committee and professor/senior Scientist at The Ottawa Hospital Research Institute and The University of Ottawa.
"The panel's priority was to formulate questions that were of significant clinical importance to both health care providers and patients," added Linda Nici, MD, co-chair of the guideline committee and professor of medicine at Brown University and Chief of Pulmonary/Critical Care at the Providence VAMC. "This clinical practice guideline is the most rigorous, outcome-driven distillation of the scientific literature to date."
The following is a summary of the recommendations, which were formulated using the Grading of Recommendations, Assessment, Development, and Evaluation approach (GRADE):
Contributors to the guideline included expert clinicians and researchers with experience in COPD.
The ATS has published nearly 20 clinical practice guidelines on various conditions, ranging from allergy and asthma to TB and other pulmonary infections. For ATS guideline implementation tools and derivatives, go here.
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American Journal of Respiratory and Critical Care Medicine