Prevention of COPD exacerbations: a European Respiratory Society/American Thoracic Society guideline
Por:
Wedzicha, JA, Calverley, PMA, Albert, RK, Anzueto, A, Criner, GJ, Hurst, JR, Miravitlles, M, Papi, A, Rabe, KF, Rigau, D, Sliwinski, P, Tonia, T, Vestbo, J, Wilson, KC, Krishnan, JA
Publicada:
1 sep 2017
Resumen:
This document provides clinical recommendations for the prevention of chronic obstructive pulmonary disease (COPD) exacerbations. It represents a collaborative effort between the European Respiratory Society and the American Thoracic Society.
Comprehensive evidence syntheses were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of COPD experts.
After considering the balance of desirable (benefits) and undesirable consequences (burden in the form of adverse effects and cost), quality of evidence, feasibility, and acceptability of various interventions, the Task Force made recommendations for mucolytic, long-acting muscarinic antagonist, phosphodiesterase-4 inhibitor (roflumilast) and macrolide therapy, as well as a conditional recommendation against fluoroquinolone therapy. All of the recommendations were conditional, except for a strong recommendation for the use of a long-acting antimuscarinic agent versus a long-acting beta(2)-adrenergic, indicating that there was uncertainty about the balance of desirable and undesirable consequences of the intervention, and that well-informed patients may make different choices regarding whether to have or not have the specific intervention.
The guideline summarises the evidence and provides recommendations for pharmacological therapy for the prevention of COPD exacerbations.
Filiaciones:
Wedzicha, JA:
Imperial Coll London, Airways Dis Sect, Natl Heart & Lung Inst, London, England
Calverley, PMA:
Univ Liverpool, Inst Ageing & Chron Dis, Liverpool, Merseyside, England
Albert, RK:
Univ Colorado, Dept Med, Aurora, CO USA
Anzueto, A:
Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA
South Texas Vet Hlth Care Syst, San Antonio, TX USA
Criner, GJ:
Temple Univ, Dept Thorac Med & Surg, Lewis Katz Sch Med, Philadelphia, PA 19122 USA
Hurst, JR:
UCL, UCL Resp, London, England
Miravitlles, M:
Hosp Univ Vall dHebron, Dept Pneumol, CIBERES, Barcelona, Spain
Papi, A:
Univ Ferrara, Dept Med Sci, Resp Med, Ferrara, Italy
Rabe, KF:
Univ Kiel, Dept Internal Med, Kiel, Germany
German Ctr Lung Res, LungenClin Grosshansdorf, Airway Res Ctr North, Grosshansdorf, Germany
Rigau, D:
Iberoamer Cochrane Ctr, Barcelona, Spain
Sliwinski, P:
Inst TB & Lung Dis, Dept Resp Med 2, Warsaw, Poland
Tonia, T:
Univ Bern, Inst Social & Prevent Med, Bern, Switzerland
Vestbo, J:
Univ Manchester, Div Infect Immun & Resp Med, Manchester, Lancs, England
Wilson, KC:
Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA
Krishnan, JA:
Univ Illinois Hosp & Hlth Sci Syst, Chicago, IL USA
Green Published, Bronze, Green Submitted
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