REVIEWS   

Minerva Pneumologica 2015 December;54(4):169-81

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Update on COPD exacerbation

Chucri S. G., Roche N.

Respiratory and Intensive Care Medicine, Cochin Hospital Group, AP‑HP, University Paris Descartes (EA2511), Sorbonne Paris Cité, Paris, France

The study was approved by the committee on research ethics at the institution in which the research was conducted and any informed consent from human subjects was obtained as required. COPD exacerbations represent a growing healthcare burden. During the last few years, new data have been emerging on the diagnosis, evaluation, management and prevention of COPD exacerbation, some of which may change the management of this condition. We now have more evidence concerning duration of glucocorticoids treatment, benefit of antibiotics and markers that can guide antibiotic therapy, noninvasive ventilation (NIV) indications, the role of mucoactive medications, and measures for prevention of COPD exacerbations like prophylactic antibiotic, chronic non-invasive ventilation, mucolytic agents, PDE-4 inhibitors, pulmonary rehabilitation or patient education. We also have evidence showing that some approaches don’t seem to provide significant benefits, like statin treatment in the absence of cardiovascular or metabolic indication, or vitamin D supplementation when there’s no vitamin D deficiency. Further studies with thorough characterization of exacerbations’ and underlying patients’ characteristics are needed to develop a more tailored strategy depending on patients’ and exacerbations’ phenotypes.