Combination bronchodilator therapy in the management of chronic obstructive pulmonary disease

Respiratory Research

Table 1 GOLD guidelines (2013): pharmacologic therapies for stable COPD^a[[9]]

Patient group	1st choice	2nd choice	Alternative
A: GOLD 1-2	Short-acting anticholinergic prn OR SABA prn	LAMA OR LABA OR SABA and short-acting anticholinergic	Theophylline
Low risk of exacerbation, less symptoms	Short-acting anticholinergic prn OR SABA prn	LAMA OR LABA OR SABA and short-acting anticholinergic	Theophylline
B: GOLD 1-2	LAMA OR LABA	LAMA and LABA	SABA and/or short-acting anticholinergic
Low risk of exacerbation, more symptoms	LAMA OR LABA	LAMA and LABA	Theophylline
C: GOLD 3-4	ICS + LABA OR LAMA	LAMA and LABA OR LAMA and PDE-4 inhibitor OR LABA and PDE-4 inhibitor	SABA and/or short-acting anticholinergic
High risk of exacerbation, less symptoms	ICS + LABA OR LAMA		Theophylline
D: GOLD 3-4	ICS + LABA and/or LAMA	ICS and LABA and LAMA OR ICS + LABA and PDE-4 inhibitor OR LAMA and LABA OR LAMA and PDE-4 inhibitor	Carbocysteine
High risk of exacerbation, more symptoms	ICS + LABA and/or LAMA		SABA and/or short-acting anticholinergic
			Theophylline

From the Global Strategy for Diagnosis, Management and Prevention of COPD 2013, Global initiative for chronic Obstructive Lung Disease (GOLD), http://www.goldcopd.org.
^aMedications in each box are mentioned in alphabetical order, and, therefore, not necessarily in order of preference.
prn = as needed; SABA = short-acting β₂-agonist; LABA = long-acting β₂-agonist, LAMA = laong-acting muscrannic antagonist; ICS = inhaled corticosteroid; PDE = phosphodiesterase.

ISSN: 1465-993X