Stepping down therapies in COPD

Abstract

Beverley Bostock-Cox explains why clinicians should regularly review their use of inhaled therapies and in some cases, step down treatment or take people off therapies The National Institute for Health and Care Excellence (NICE) guidelines for chronic obstructive pulmonary disease (COPD) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have key differences in treatment. These discrepancies reflect a growing understanding about the risks and benefits of the inhaled therapies on the market, which was not available when NICE published its guidance but which is reflected in the GOLD guidelines. Clinicians should be able to differentiate between different COPD phenotypes based on the history and the GOLD ABCD algorithm, and recognise the different drug classes which are indicated for each category. It is important to regularly review patients' use of inhaled therapies and in some cases, step people with COPD down or off treatment.