ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: Questions and Answers

作者：Montes de Oca Maria; Victorina Lopez Varela Maria; Acuna Agustin; Schiavi Eduardo; Alejandra Rey Maria; Jardime Jose; Casas Alejandro; Tokumoto Antonio; Duque Carlos A Torres; Ramirez Venegash Alejandra; Garcia Gabriel; Stirbulov Roberto; Camelier Aquiles; Bergna Miguel; Cohen Mark; Guzman Santiago; Sanchez Efrain

来源：Archivos de Bronconeumologia, 2015, 51(8): 403-416.

DOI：10.1016/j.arbres.2014.11.017

• Clinical practice guideline
• Chronic obstructive pulmonary disease (COPD)

ALAT-2014 COPD Clinical Practice Guidelines used clinical questions in PICO format to compile evidence related to risk factors, COPD screening, disease prognosis, treatment and exacerbations. Evidence reveals the existence of risk factors for COPD other than tobacco, as well as gender differences in disease presentation. It shows the benefit of screening in an at-risk population, and the predictive value use of multidimensional prognostic indexes. In stable COPD, similar benefits in dyspnea, pulmonary function and quality of life are achieved with LAMA or LABA long-acting bronchodilators, whereas LAMA is more effective in preventing exacerbations. Dual bronchodilator therapy has more benefits than monotherapy. LAMA and combination LABA/IC are similarly effective, but there is an increased risk of pneumonia with LABA/IC. Data on the efficacy and safety of triple therapy are scarce. Evidence supports influenza vaccination in all patients and anti-pneumococcal vaccination in patients <65 years of age and/or with severe airflow limitation. Antibiotic prophylaxis may decrease exacerbation frequency in patients at risk. The use of systemic corticosteroids and antibiotics are justified in exacerbations requiring hospitalization and in some patients managed in an outpatient setting.

• 出版日期2015-8