Recommendations for the pharmacological treatment of COPD: questions and answers

Frederico Leon Arrabal Fernandes Alberto Cukier Aquiles Assunção Camelier Carlos Cezar Fritscher Cláudia Henrique da Costa Eanes Delgado Barros Pereira Irma Godoy José Eduardo Delfini Cançado José Gustavo Romaldini Jose Miguel Chatkin José Roberto Jardim Marcelo Fouad Rabahi Maria Cecília Nieves Maiorano de Nucci Maria da Penha Uchoa Sales Maria Vera Cruz de Oliveira Castellano Miguel Abidon Aidé Paulo José Zimermann Teixeira Renato Maciel Ricardo de Amorim Corrêa Roberto Stirbulov Rodrigo Abensur Athanazio Rodrigo Russo Suzana Tanni Minamoto Fernando Luiz Cavalcanti Lundgren About the authors

ABSTRACT

The treatment of COPD has become increasingly effective. Measures that range from behavioral changes, reduction in exposure to risk factors, education about the disease and its course, rehabilitation, oxygen therapy, management of comorbidities, and surgical and pharmacological treatments to end-of-life care allow health professionals to provide a personalized and effective therapy. The pharmacological treatment of COPD is one of the cornerstones of COPD management, and there have been many advances in this area in recent years. Given the greater availability of drugs and therapeutic combinations, it has become increasingly challenging to know the indications for, limitations of, and potential risks and benefits of each treatment modality. In order to critically evaluate recent evidence and systematize the major questions regarding the pharmacological treatment of COPD, 24 specialists from all over Brazil gathered to develop the present recommendations. A visual guide was developed for the classification and treatment of COPD, both of which were adapted to fit the situation in Brazil. Ten questions were selected on the basis of their relevance in clinical practice. They address the classification, definitions, treatment, and evidence available for each drug or drug combination. Each question was answered by two specialists, and then the answers were consolidated in two phases: review and consensus by all participants. The questions answered are practical questions and help select from among the many options the best treatment for each patient and his/her peculiarities.

Keywords:
Pulmonary disease, chronic obstructive/drug therapy; pulmonary disease, chronic obstructive/prevention & control; pulmonary disease, chronic obstructive/therapy

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