TY - JOUR T1 - Differences in the recommended initial therapy of COPD according to GOLD guidelines 2006 and 2011 JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - 1649 AU - Ivan Vyshnyvetskyy AU - Yuriy Mostovoy AU - Olexiy Onyshchenko Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/1649.abstract N2 - Background. The last GOLD Guideline revision was released in late 2011. We hypothesized that newer GOLD guidelines would frequently lead to a differnent initital treatment choice.Aims and objectives. To demonstrate the magnitude of difference in recommended initial treatments in COPD patients based on past and recent GOLD revisions.Methods. We retrospectively analyzed 52 patients with first diagnosed stable COPD. Spirometry, COPD Assessment Test and evaluation of exacerbations were done. Patients were allocated to the most appropriate treatment according to GOLD 2006 and 2011 management scheme.Results. According to GOLD 2006 criteria 32 (61,5%), 18 (34,6%) and 2 (3,8%) patients were stage II, III and IV, respectively. Forty (76,9%) patients should be prescribed monotherapy with LABA or LAMA and 12 (23,1%) required ICS/LABA therapy. According to GOLD 2011 6 (11,5%), 19 (36,5%), 2 (3,8%) and 25 (48,1%) patients were Group A, B, C and D, respectively. Thus, 6 (11,5%) patients would not be prescribed long-acting bronchodilators (BD) as initial therapy, 20 (38,5%) patients required monotherapy with long-acting BD and 26 (50,0%) required therapy with ICS/LABA. In accordance with GOLD 2011 treatment scheme, initial therapy was required to be changed in 21 (40,4%) patients (13 (40,6%) stage II and 8 (40,0%) stage III-IV). In 6 (11,5%) cases we had to administer more “light” therapy (with short-acting BD instead of long-acting BD), and 14 (26,9%) patient required more intensive treatment, usually LABA/ICS instead of monotherapy.Conclusions. In significant proportion of COPD patients GOLD 2011 treatment scheme leads to another, generally more intensive, initial treatment. ER -