COPD : a stepwise or a hit hard approach?

Detalhes bibliográficos
Autor(a) principal: Ferreira, A. J.
Data de Publicação: 2016
Outros Autores: Reis, A., Marçal, N., Pinto, P., Bárbara, C.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/27426
Resumo: Open Access funded by Sociedade Portuguesa de Pneumologia Under a Creative Commons license. © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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spelling COPD : a stepwise or a hit hard approach?COPDStepwiseHit hardStep-upICS withdrawalBronchodilatorsICSOpen Access funded by Sociedade Portuguesa de Pneumologia Under a Creative Commons license. © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Current guidelines differ slightly on the recommendations for treatment of Chronic Obstructive Pulmonary Disease (COPD) patients, and although there are some undisputed recommendations, there is still debate regarding the management of COPD. One of the hindrances to deciding which therapeutic approach to choose is late diagnosis or misdiagnosis of COPD. After a proper diagnosis is achieved and severity assessed, the choice between a stepwise or "hit hard" approach has to be made. For GOLD A patients the stepwise approach is recommended, whilst for B, C and D patients this remains debatable. Moreover, in patients for whom inhaled corticosteroids (ICS) are recommended, a step-up or "hit hard" approach with triple therapy will depend on the patient's characteristics and, for patients who are being over-treated with ICS, ICS withdrawal should be performed, in order to optimize therapy and reduce excessive medications. This paper discusses and proposes stepwise, "hit hard", step-up and ICS withdrawal therapeutic approaches for COPD patients based on their GOLD group. We conclude that all approaches have benefits, and only a careful patient selection will determine which approach is better, and which patients will benefit the most from each approach.Funding for this paper was provided by Novartis Portugal. Funding was used to access all necessary scientific bibliography and cover meeting expenses. Novartis Portugal had no role in the collection, analysis and interpretation of data, in the writing of the paper and in the decision to submit the paper for publication.Elsevier EspañaRepositório da Universidade de LisboaFerreira, A. J.Reis, A.Marçal, N.Pinto, P.Bárbara, C.2017-04-11T09:54:22Z20162016-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/27426engRev Port Pneumol. 2016;22(4):214-2212173-511510.1016/j.rppnen.2015.12.012info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-11-20T17:34:31Zoai:repositorio.ul.pt:10451/27426Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-11-20T17:34:31Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv COPD : a stepwise or a hit hard approach?
title COPD : a stepwise or a hit hard approach?
spellingShingle COPD : a stepwise or a hit hard approach?
Ferreira, A. J.
COPD
Stepwise
Hit hard
Step-up
ICS withdrawal
Bronchodilators
ICS
title_short COPD : a stepwise or a hit hard approach?
title_full COPD : a stepwise or a hit hard approach?
title_fullStr COPD : a stepwise or a hit hard approach?
title_full_unstemmed COPD : a stepwise or a hit hard approach?
title_sort COPD : a stepwise or a hit hard approach?
author Ferreira, A. J.
author_facet Ferreira, A. J.
Reis, A.
Marçal, N.
Pinto, P.
Bárbara, C.
author_role author
author2 Reis, A.
Marçal, N.
Pinto, P.
Bárbara, C.
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Ferreira, A. J.
Reis, A.
Marçal, N.
Pinto, P.
Bárbara, C.
dc.subject.por.fl_str_mv COPD
Stepwise
Hit hard
Step-up
ICS withdrawal
Bronchodilators
ICS
topic COPD
Stepwise
Hit hard
Step-up
ICS withdrawal
Bronchodilators
ICS
description Open Access funded by Sociedade Portuguesa de Pneumologia Under a Creative Commons license. © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
publishDate 2016
dc.date.none.fl_str_mv 2016
2016-01-01T00:00:00Z
2017-04-11T09:54:22Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/27426
url http://hdl.handle.net/10451/27426
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Rev Port Pneumol. 2016;22(4):214-221
2173-5115
10.1016/j.rppnen.2015.12.012
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier España
publisher.none.fl_str_mv Elsevier España
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv mluisa.alvim@gmail.com
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