Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jul-Aug;43(4):290-301.
doi: 10.1590/S1806-37562017000000153.

Recommendations for the pharmacological treatment of COPD: questions and answers

[Article in English, Portuguese]
Frederico Leon Arrabal Fernandes  1 , Alberto Cukier  1 , Aquiles Assunção Camelier  2   3 , Carlos Cezar Fritscher  4 , Cláudia Henrique da Costa  5 , Eanes Delgado Barros Pereira  6 , Irma Godoy  7 , José Eduardo Delfini Cançado  8 , José Gustavo Romaldini  8 , Jose Miguel Chatkin  4 , José Roberto Jardim  9 , Marcelo Fouad Rabahi  10 , Maria Cecília Nieves Maiorano de Nucci  11 , Maria da Penha Uchoa Sales  12 , Maria Vera Cruz de Oliveira Castellano  13 , Miguel Abidon Aidé  14 , Paulo José Zimermann Teixeira  15   16 , Renato Maciel  17 , Ricardo de Amorim Corrêa  18 , Roberto Stirbulov  8 , Rodrigo Abensur Athanazio  1 , Rodrigo Russo  19 , Suzana Tanni Minamoto  7 , Fernando Luiz Cavalcanti Lundgren  20
Affiliations
Review

Recommendations for the pharmacological treatment of COPD: questions and answers

[Article in English, Portuguese]
Frederico Leon Arrabal Fernandes et al. J Bras Pneumol. 2017 Jul-Aug.

Abstract
in English, Portuguese

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.

O tratamento da DPOC vem se tornando cada vez mais eficaz. Medidas que envolvem desde mudanças comportamentais, redução de exposições a fatores de risco, educação sobre a doença e seu curso, reabilitação, oxigenoterapia, manejo de comorbidades, tratamentos cirúrgicos e farmacológicos até os cuidados de fim de vida permitem ao profissional oferecer uma terapêutica personalizada e efetiva. O tratamento farmacológico da DPOC constitui um dos principais pilares desse manejo, e muitos avanços têm sido atingidos na área nos últimos anos. Com a maior disponibilidade de medicações e combinações terapêuticas fica cada vez mais desafiador conhecer as indicações, limitações, potenciais riscos e benefícios de cada tratamento. Com o intuito de avaliar criticamente a evidência recente e sistematizar as principais dúvidas referentes ao tratamento farmacológico da DPOC, foram reunidos 24 especialistas de todo o Brasil para elaborar a presente recomendação. Foi elaborado um guia visual para a classificação e tratamento adaptados à nossa realidade. Dez perguntas foram selecionadas pela relevância na prática clínica. Abordam a classificação, definições, tratamento e evidências disponíveis para cada medicação ou combinação. Cada pergunta foi respondida por dois especialistas e depois consolidadas em duas fases: revisão e consenso entre todos os participantes. As questões respondidas são dúvidas práticas e ajudam a selecionar qual o melhor tratamento, entre as muitas opções, para cada paciente com suas particularidades.

PubMed Disclaimer

Figures

Chart 1
Chart 1. Main drugs for the treatment of COPD.a
Chart 2
Chart 2. Classification and pharmacological treatment of COPD.
Chart 3
Chart 3. Adapted version of the Modified Medical Research Council dyspnea scale for use in Brazil.
Chart 4
Chart 4. Portuguese-language version of the COPD Assessment Test.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007;356(8):775–789. https://doi.org/10.1056/NEJMoa063070 - DOI - PubMed
    1. Menezes AM, Macedo SE, Noal RB, Fiterman J, Cukier A, Chatkin JM. Pharmacological treatment of COPD. J Bras Pneumol. 2011;37(4):527–543. https://doi.org/10.1590/S1806-37132011000400016 - DOI - PubMed
    1. Reichert J, Araújo AJ, Gonçalves CM, Godoy I, Chatkin JM, Sales MP. Diretrizes para cessação do tabagismo da SBPT 2008. J Bras Pneumol. 2008;34(10):845–880. https://doi.org/10.1590/S1806-37132008001000014 - DOI - PubMed
    1. Global Initiative for Chronic Obstructive Lung Disease . Global Strategy for the Diagnosis, Management and Prevention of COPD. Bethesda: GOLD; 2016. http://www.goldcopd.org - PubMed
    1. Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res. 2010;11:122–122. https://doi.org/10.1186/1465-9921-11-122 - DOI - PMC - PubMed

MeSH terms