GOLD 2023 COPD

Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary

The 2023 revision is the largest since 2011 and changes what a COPD patient is called before it changes what they are given. The ABCD assessment loses its C and D: exacerbation history now decides on its own, so groups C and D merge into a single E, and the symptom axis no longer splits the high-risk patient in two. The definition itself widens, with the disease framed by its lifetime trajectory rather than by smoking alone, and pre-COPD and PRISm named as states that precede airflow obstruction without yet being it. Initial therapy for group E is dual bronchodilation, with an inhaled corticosteroid added where the blood eosinophil count is 300 cells per microlitre or higher; the eosinophil count is the biomarker the document leans on hardest. The register's bronchodilator, corticosteroid and screening trials are grouped below.

This guideline cites 7 of the 35 landmark trials in our Pulmonology register.

Source
Agustí A, Celli BR, Criner GJ, et al. Eur Respir J. 2023;61(4):2300239. · European Respiratory Journal

Triple therapy & the eosinophil threshold3

  • 2020ETHOSPulmonology · COPD · Single-inhaler tripleBudesonide/Glycopyrrolate/Formoterol Triple Therapy in COPD
  • 2018IMPACTPulmonology · COPD · Single-inhaler tripleInforming the Pathway of COPD Treatment
  • 2014WISDOMPulmonology · COPD · ICS withdrawalWithdrawal of Inhaled Steroids During Optimised Bronchodilator Management

Treating the exacerbation1

  • 2013REDUCEPulmonology · COPD · Steroid durationReduction in the Use of Corticosteroids in Exacerbated COPD

Before airflow obstruction: pre-COPD and PRISm1

  • 2022RETHINCPulmonology · COPD · Preserved spirometryBronchodilators in Tobacco-Exposed Persons with Symptoms and Preserved Lung Function

Lung cancer screening in the smoker2

  • 2020NELSONPulmonology · LCS · Low-dose CTDutch-Belgian Lung Cancer Screening Trial
  • 2011NLSTPulmonology · LCS · Low-dose CTNational Lung Screening Trial