Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, China.
Ther Adv Respir Dis. 2023 Jan-Dec;17:17534666231213715. doi: 10.1177/17534666231213715.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report revised the combined assessment, merged the C and D groups into the E group, and revised the initial inhalation therapy recommendation.
This study aimed to analyze the future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease (COPD) in various groups based on the GOLD 2017 and GOLD 2023 reports.
This is a multicenter and retrospective study.
Stable COPD patients from the database setup by 12 hospitals were enrolled. The patients were divided into Groups A, B, C, D, and E according to the GOLD 2017 and GOLD 2023 reports. Then, the patients were classified into long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS subgroups. Data on exacerbation and death during 1 year of follow-up were collected.
A total of 4623 patients were classified into Group A (15.0%), Group B (37.8%), Group C (7.3%), Group D (39.9%), and Group E (47.2%). The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies in Groups A and C. Patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbation and frequent exacerbation than patients treated with LAMA or LABA + ICS in Groups B, D, and E. The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies after combining Groups A with C.
Patients in Group A should be recommended to undergo mono-LAMA, while patients in Groups B and E should be recommended treatment with LABA + LAMA, which is consistent with the GOLD 2023 report. However, it is worth considering merging Groups A and C into a single group and recommending mono-LAMA as the initial inhalation therapy.
全球慢性阻塞性肺疾病倡议（GOLD）2023 年报告修订了综合评估，将 C 组和 D 组合并为 E 组，并修订了初始吸入治疗建议。
本研究旨在根据 GOLD 2017 年和 GOLD 2023 年报告，分析不同吸入疗法在不同 GOLD 组 COPD 患者中的未来加重和死亡情况。
这是一项多中心回顾性研究。
从 12 家医院建立的数据库中纳入稳定期 COPD 患者。根据 GOLD 2017 年和 GOLD 2023 年报告，患者被分为 A、B、C、D 和 E 组。然后，将患者分为长效抗胆碱能药物（LAMA）、长效β2-激动剂（LABA）+吸入皮质类固醇（ICS）、LABA+LAMA、LABA+LAMA+ICS 亚组。收集随访 1 年内的加重和死亡数据。
共纳入 4623 例患者，分为 A 组（15.0%）、B 组（37.8%）、C 组（7.3%）、D 组（39.9%）和 E 组（47.2%）。A 组和 C 组中，不同吸入疗法的加重、频繁加重和死亡率无差异。B 组、D 组和 E 组中，与 LAMA 或 LABA+ICS 相比，LABA+LAMA 或 LABA+LAMA+ICS 治疗的患者加重和频繁加重发生率较低。A 组和 C 组合并后，不同吸入疗法的加重、频繁加重和死亡率无差异。
A 组患者应推荐使用单 LAMA，B 组和 E 组患者应推荐使用 LABA+LAMA，与 GOLD 2023 年报告一致。然而，值得考虑将 A 组和 C 组合并为一个单一的组，并推荐单 LAMA 作为初始吸入治疗。
