• Pharmacologic treatment recommendations are tailored to patients' needs based on symptoms and exacerbation history1
• LAMA/LABA therapy now an essential cornerstone for COPD treatment across the spectrum of people with COPD in GOLD groups B-D1
• Clearer guidance for physicians on which subset of patients may benefit from the addition of ICS1

Boehringer Ingelheim welcomes the updated 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Strategy which now positions a combination of a LAMA (long-acting anticholinergic) and a LABA (long-acting beta2-agonist), as a mainstay treatment for people with Chronic Obstructive Pulmonary Disease (COPD) in GOLD groups B-D.1 This represents a significant change versus previous GOLD guidelines.

The new Strategy classifies people with COPD by symptoms and history of exacerbations only. It still uses the A, B, C, D system, with each category having its own treatment algorithm supporting a more tailored approach addressing patient needs. For GOLD groups B-D, LAMA/LABA therapy plays a critical, central role in the treatment recommendations.

"This is a major revision of the GOLD document since 2011 and is a step forward for individualised COPD management. The updated pharmacotherapy recommendations are now based solely on two factors, symptoms and exacerbation history," said Professor Claus Vogelmeier, MD, Chair, GOLD Science Committee, Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany. "Our 2017 Global Strategy aims to help people with this chronic but treatable condition by offering holistic treatment guidance that covers pharmacological and non-pharmacological treatments."

The 2017 GOLD Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease reflects the latest evidence from published scientific research.1 The added benefits of treatment with a LAMA/LABA beyond the monocomponents alone, and versus LABA/ICS (inhaled corticosteroids) for people with COPD, have been consistently confirmed by a number of randomised, clinical trials.2,3,4,5,6,7,8,9

The evidence includes results from the large-scale, Phase III TOviTO® clinical trial programme. The data also demonstrate Spiolto® Respimat® (tiotropium+olodaterol) provides significant improvements in patient outcomes over Spiriva® Respimat® (tiotropium), right from the initial stages when people with COPD need maintenance therapy.6,7,8,10,11

The new GOLD Strategy provides clear guidance on when, and in which patients, ICS can be added or withdrawn.1 All COPD patients should be treated with therapies that optimise lung function first. Only those who have ≥2 exacerbations per year or ≥1 exacerbation leading to hospital admission may be considered for an ICS-containing therapy after LAMA/LABA. In addition, the new GOLD Strategy suggests that ICS therapy may be withdrawn safely in people with COPD who are in GOLD group D and stable, by using a LAMA/LABA regimen.1

Several studies, including the Withdrawal of Inhaled Steroids During Optimised bronchodilator Management (WISDOM) study,12,13,14,15 have helped inform the de-escalation path. “Boehringer Ingelheim is pleased that our extensive, ongoing clinical trial programme in COPD has contributed to the latest GOLD Strategy. We are committed to continuing research into the optimal management of COPD to achieve the best possible outcomes for people with COPD,” said Dr William Mezzanotte, MD MPH, Vice President and Head of Respiratory Medicine at Boehringer Ingelheim.

COPD is a serious but manageable lung disease, which is estimated to affect 210 million people worldwide.16 Total deaths from COPD are projected to increase by more than 30 percent in the next 10 years; COPD is predicted to become the third leading cause of death globally by 2030.17 Once daily Spiolto® Respimat® is Boehringer Ingelheim’s advance in COPD maintenance treatment, and has been approved in more than 50 countries worldwide.