Time To Revise COPD Treatment Algorithm

In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after...

Full description

Saved in:

Bibliographic Details
Published in:	International journal of chronic obstructive pulmonary disease Vol. 14; pp. 2229 - 2234
Main Authors:	Matsunaga, Kazuto, Oishi, Keiji, Miravitlles, Marc, Anzueto, Antonio
Format:	Journal Article
Language:	English
Published:	New Zealand Dove Medical Press Limited 01.09.2019 Dove Medical Press Ltd Dove Dove Medical Press
Subjects:	Administration, Inhalation Adrenal Cortex Hormones - administration & dosage Algorithms Anxiety Asthma Bronchitis Chronic obstructive lung disease Chronic obstructive pulmonary disease Clinical medicine Decision Trees Drug therapy Dyspnea Gastroesophageal reflux Gene expression Health aspects Heart failure Humans ICS Infection Inflammation Inhalers Medical research Osteoporosis parallel approach Patient satisfaction personalized therapy Pharmaceutical industry Phenotypes Practice Guidelines as Topic Pulmonary Disease, Chronic Obstructive - drug therapy Quality of life Respiratory system agents Roflumilast Steroids treatable traits United Kingdom Switzerland ICS treatable traits parallel approach personalized therapy
ISSN:	1178-2005, 1176-9106, 1178-2005
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Abstract	In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective β1-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients' clinical characteristics and on personalized therapy.
AbstractList	In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective β1-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients' clinical characteristics and on personalized therapy.In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective β1-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients' clinical characteristics and on personalized therapy. Kazuto Matsunaga,1 Keiji Oishi,2 Marc Miravitlles,3 Antonio Anzueto4,5 1Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan; 2Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan; 3Department of Pneumology, Hospital Universitari Vall d'Hebron/Vall d'Hebron Research Institute (VHIR), Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 4Division of Pulmonary Diseases and Critical Care Medicine, School of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA; 5Pulmonary Diseases Section, Audie L. Murphy Memorial VA Hospital, South Texas Veterans Health Care System, San Antonio, TX, USACorrespondence: Kazuto MatsunagaDepartment of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, Yamaguchi 755-8505, JapanTel +81 836 85 3123Fax +81 836 85 3124Email kazmatsu@yamaguchi-u.ac.jpAbstract: In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective β1-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients' clinical characteristics and on personalized therapy.Keywords: parallel approach, treatable traits, ICS, personalized therapy In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective (31-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients' clinical characteristics and on personalized therapy. Keywords: parallel approach, treatable traits, ICS, personalized therapy In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective β1-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients’ clinical characteristics and on personalized therapy. In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable traits, and patient-specialised assessment targeting eosinophilic inflammation, chronic bronchitis, and frequent infections is recommended after exacerbation occurs despite maximal bronchodilation therapy. However, recent studies have revealed the clinical characteristics of patients who should have second controllers added, such as ICS. We again realized that treatable traits should be assessed and intervened for as early as possible. Moreover, the treatment algorithm is necessary to be adapted to the situation of clinical practice, taking into account the characteristics of the patients. The time to revise COPD treatment algorithm has come and we propose a new 3-step parallel approach for initial COPD treatment. After the diagnosis of COPD, the first assessment is to divide into two categories based on the usual clinical characteristics for patients with COPD and the specific clinical characteristics for each patient with concomitant disease. In the former, the assessment should be based on the level of dyspnea and the frequency of exacerbations. After the assessment, mono- or dual bronchodilator should be selected. In the latter, the assessment should be based on asthma characteristics, chronic bronchitis, and chronic heart failure. After the assessment, patients with asthmatic characteristics may consider treatment with ICS, while patients with chronic bronchitis may consider treatment with roflumilast and/or macrolide, while patients with chronic heart failure may consider treatment with selective (31-blocker. The 3-step parallel approach is completed by adding an additional therapy for patients with concomitant disease to essential therapy for patients with COPD. In addition, it is important to review the response around 4 weeks after the initial therapy. This COPD management proposal might be considered as an approach based on patients' clinical characteristics and on personalized therapy.
Audience	Academic
Author	Miravitlles, Marc Oishi, Keiji Matsunaga, Kazuto Anzueto, Antonio
Author_xml	– sequence: 1 givenname: Kazuto orcidid: 0000-0002-0514-3241 surname: Matsunaga fullname: Matsunaga, Kazuto – sequence: 2 givenname: Keiji orcidid: 0000-0003-4230-0450 surname: Oishi fullname: Oishi, Keiji – sequence: 3 givenname: Marc orcidid: 0000-0002-9850-9520 surname: Miravitlles fullname: Miravitlles, Marc – sequence: 4 givenname: Antonio surname: Anzueto fullname: Anzueto, Antonio
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/31631994$$D View this record in MEDLINE/PubMed
BookMark	eNptktuLEzEUh4OsuBd981kGBPXB1lxmcnkRSr0tLKxofQ5JJmlTZia7SWbB_96MrWu7LOch4eQ7v5NzOQcnQxgsAC8RnGNUsw_L6--f5j8xErBBT8AZQozPMITNycH9FJyntC0Xyhh6Bk4JogQJUZ-Btyvf22oVqh_2zidbTWrVKlqVezvkatGtQ_R50z8HT53qkn2xPy_Ary-fV8tvs6vrr5fLxdXM0BrnGUfIUUuI0IgzjDWyyBnqWs4JwpQ43nKsHCWiEY5BpWwDNaVE67pVtRaOXIDLnW4b1FbeRN-r-FsG5eVfR4hrqWL2prNSYMV5icEUwppBrosxghHUxKhGw6L1cad1M-retqYUFFV3JHr8MviNXIc7WbpEMRdF4N1eIIbb0aYse5-M7To12DAmiQlkRBDGJvT1A3QbxjiUVklMmWgQ4RT-p9aqFOAHF0peM4nKBYV1GZcgTaHmj1DFWtt7U6bvfPEfBbw5CNhY1eVNCt2YfRjSMfjqsCP3rfi3DwV4vwNMDClF6-4RBOW0bnJaELlft4LjB7jxWU1py49993jQH7GT0co
CitedBy_id	crossref_primary_10_2147_COPD_S291920 crossref_primary_10_1177_17534666231208630 crossref_primary_10_1016_j_lfs_2021_119568 crossref_primary_10_3390_jcm9030710 crossref_primary_10_3390_jcm9103078 crossref_primary_10_2147_COPD_S367553 crossref_primary_10_1016_j_resinv_2020_05_006
ContentType	Journal Article
Copyright	2019 Matsunaga et al. COPYRIGHT 2019 Dove Medical Press Limited 2019. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2019 Matsunaga et al. 2019 Matsunaga et al.
Copyright_xml	– notice: 2019 Matsunaga et al. – notice: COPYRIGHT 2019 Dove Medical Press Limited – notice: 2019. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2019 Matsunaga et al. 2019 Matsunaga et al.
DBID	AAYXX CITATION CGR CUY CVF ECM EIF NPM 3V. 7RV 7X7 7XB 88E 8C1 8FI 8FJ 8FK ABUWG AFKRA AZQEC BENPR CCPQU DWQXO FYUFA GHDGH K9. KB0 M0S M1P NAPCQ PHGZM PHGZT PIMPY PJZUB PKEHL PPXIY PQEST PQQKQ PQUKI 7X8 5PM DOA
DOI	10.2147/COPD.S219051
DatabaseName	CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed ProQuest Central (Corporate) Nursing & Allied Health Database Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) Public Health Database Hospital Premium Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest Central UK/Ireland ProQuest Central Essentials - QC ProQuest Central ProQuest One Community College ProQuest Central Korea Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Health & Medical Complete (Alumni) Nursing & Allied Health Database (Alumni Edition) ProQuest Health & Medical Collection Medical Database Nursing & Allied Health Premium ProQuest Central Premium ProQuest One Academic (New) Publicly Available Content Database ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic (retired) ProQuest One Academic UKI Edition MEDLINE - Academic PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals
DatabaseTitle	CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) Publicly Available Content Database ProQuest One Academic Middle East (New) ProQuest Central Essentials ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Central ProQuest Health & Medical Research Collection Health Research Premium Collection Health and Medicine Complete (Alumni Edition) ProQuest Central Korea Health & Medical Research Collection ProQuest Central (New) ProQuest Medical Library (Alumni) ProQuest Public Health ProQuest One Academic Eastern Edition ProQuest Nursing & Allied Health Source ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Hospital Collection (Alumni) Nursing & Allied Health Premium ProQuest Health & Medical Complete ProQuest Medical Library ProQuest One Academic UKI Edition ProQuest Nursing & Allied Health Source (Alumni) ProQuest One Academic ProQuest One Academic (New) ProQuest Central (Alumni) MEDLINE - Academic
DatabaseTitleList	MEDLINE - Academic Publicly Available Content Database MEDLINE
Database_xml	– sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: 7RV name: ProQuest Nursing & Allied Health Source url: https://search.proquest.com/nahs sourceTypes: Aggregation Database
DeliveryMethod	fulltext_linktorsrc
Discipline	Medicine
DocumentTitleAlternate	Matsunaga et al
EISSN	1178-2005
EndPage	2234
ExternalDocumentID	oai_doaj_org_article_92a88b9f26004708b8b873210b3ca5b0 PMC6776289 A604178935 31631994 10_2147_COPD_S219051
Genre	Journal Article
GeographicLocations	United Kingdom Switzerland
GeographicLocations_xml	– name: United Kingdom – name: Switzerland
GroupedDBID	--- 0YH 29J 2WC 53G 5GY 5VS 7RV 7X7 88E 8C1 8FI 8FJ AAYXX ABUWG ADBBV ADRAZ AENEX AFFHD AFKRA ALMA_UNASSIGNED_HOLDINGS AOIJS AQTUD BAWUL BCNDV BENPR C1A CCPQU CITATION CS3 DIK E3Z EBS EJD EMOBN F5P FYUFA GROUPED_DOAJ GX1 HMCUK HYE IAO IHR IHW INH INR ITC KQ8 M1P M48 M~E NAPCQ O5R O5S OK1 PGMZT PHGZM PHGZT PIMPY PJZUB PPXIY PSQYO RNS RPM TDBHL TR2 UKHRP VDV CGR CUY CVF ECM EIF NPM 3V. 7XB 8FK AZQEC DWQXO K9. PKEHL PQEST PQQKQ PQUKI 7X8 PUEGO 5PM
ID	FETCH-LOGICAL-c642t-811f6e339b18722b1e1fc6fd8831263f8d82af63959f70aae50b663bb4da4b9f3
IEDL.DBID	7RV
ISICitedReferencesCount	9
ISICitedReferencesURI	http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000489161200001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
ISSN	1178-2005 1176-9106
IngestDate	Fri Oct 03 12:53:33 EDT 2025 Tue Nov 04 01:48:31 EST 2025 Thu Oct 02 10:18:15 EDT 2025 Tue Oct 07 07:22:13 EDT 2025 Tue Nov 11 10:17:01 EST 2025 Tue Nov 04 17:03:02 EST 2025 Thu May 22 21:22:19 EDT 2025 Thu Jan 02 22:57:59 EST 2025 Tue Nov 18 22:33:54 EST 2025 Sat Nov 29 04:49:06 EST 2025
IsDoiOpenAccess	true
IsOpenAccess	true
IsPeerReviewed	true
IsScholarly	true
Keywords	ICS treatable traits parallel approach personalized therapy
Language	English
License	http://creativecommons.org/licenses/by-nc/3.0 2019 Matsunaga et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
LinkModel	DirectLink
MergedId	FETCHMERGED-LOGICAL-c642t-811f6e339b18722b1e1fc6fd8831263f8d82af63959f70aae50b663bb4da4b9f3
Notes	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ORCID	0000-0002-0514-3241 0000-0002-9850-9520 0000-0003-4230-0450
OpenAccessLink	https://www.proquest.com/docview/2679513860?pq-origsite=%requestingapplication%
PMID	31631994
PQID	2679513860
PQPubID	5500198
PageCount	6
ParticipantIDs	doaj_primary_oai_doaj_org_article_92a88b9f26004708b8b873210b3ca5b0 pubmedcentral_primary_oai_pubmedcentral_nih_gov_6776289 proquest_miscellaneous_2307393779 proquest_journals_2679513860 gale_infotracmisc_A604178935 gale_infotracacademiconefile_A604178935 gale_healthsolutions_A604178935 pubmed_primary_31631994 crossref_primary_10_2147_COPD_S219051 crossref_citationtrail_10_2147_COPD_S219051
PublicationCentury	2000
PublicationDate	2019-09
PublicationDateYYYYMMDD	2019-09-01
PublicationDate_xml	– month: 09 year: 2019 text: 2019-09
PublicationDecade	2010
PublicationPlace	New Zealand
PublicationPlace_xml	– name: New Zealand – name: London
PublicationTitle	International journal of chronic obstructive pulmonary disease
PublicationTitleAlternate	Int J Chron Obstruct Pulmon Dis
PublicationYear	2019
Publisher	Dove Medical Press Limited Dove Medical Press Ltd Dove Dove Medical Press
Publisher_xml	– name: Dove Medical Press Limited – name: Dove Medical Press Ltd – name: Dove – name: Dove Medical Press
SSID	ssj0056771
Score	2.259065
Snippet	In 2017, a new two-step algorithm for the treatment of COPD was proposed. This algorithm was based on the severity of symptoms and phenotypes or treatable... Kazuto Matsunaga,1 Keiji Oishi,2 Marc Miravitlles,3 Antonio Anzueto4,5 1Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine,...
SourceID	doaj pubmedcentral proquest gale pubmed crossref
SourceType	Open Website Open Access Repository Aggregation Database Index Database Enrichment Source
StartPage	2229
SubjectTerms	Administration, Inhalation Adrenal Cortex Hormones - administration & dosage Algorithms Anxiety Asthma Bronchitis Chronic obstructive lung disease Chronic obstructive pulmonary disease Clinical medicine Decision Trees Drug therapy Dyspnea Gastroesophageal reflux Gene expression Health aspects Heart failure Humans ICS Infection Inflammation Inhalers Medical research Osteoporosis parallel approach Patient satisfaction personalized therapy Pharmaceutical industry Phenotypes Practice Guidelines as Topic Pulmonary Disease, Chronic Obstructive - drug therapy Quality of life Respiratory system agents Roflumilast Steroids treatable traits
SummonAdditionalLinks	– databaseName: DOAJ Directory of Open Access Journals dbid: DOA link: http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV1Lb9QwEB6hqkJcEC2vQIEggXpAUeM4fh2XlooDlEosUm-W7djtSiWpdrf9_R3H2WgjhLig3OKJ5Hwz45lJxp8BPjTCOsd5WTBhLBYohhUqCFUwZyvSUFcr1_PMfhNnZ_LiQp1vHfUVe8ISPXAC7khVRkqrQiRSr0UpLV4ibjyx1Blm-2ods55NMZXWYMZFKrWI6O2ApZb3eCbPketucGFCRy0ZmQSjnrP_z5V5KzRN2ya34tDpE3g8JJD5LE18Dx74dh8efh9-kT-Fw7ipI593efzqv_L58Y_zk3y-aSfPZ9eX3XKxvvr9DH6dfpkffy2G0xAKhzXCupCEBO4pVZZIUVWWeBIcD42UlFScBtnIygRMOBiCXRrjWWkxnbC2bkyNANLnsNN2rX8JucenXI3h0cYIHYIJVDnMPGjwRjDjMvi0gUW7gSo8nlhxrbFkiCDqOHf9M4GYwcdR-iZRZPxF7nNEeJSJxNb9DVS3HtSt_6XuDN5F_ei0S3R0Tz3jZY3KVpRlcNhLRAfFSTsz7DPAV49UVxPJg4kkOpabDm9sQA-OvdIVF5iTUslxJu_H4fhkbFZrfXeLMjTxDAqVwYtkMuNLU8x_Ix1zBmJiTBNUpiPt4qqn_Uab5lgev_ofML6GR5j5Dc1yB7CzXt76N7Dr7taL1fJt70v3H0QeoQ priority: 102 providerName: Directory of Open Access Journals
Title	Time To Revise COPD Treatment Algorithm
URI	https://www.ncbi.nlm.nih.gov/pubmed/31631994 https://www.proquest.com/docview/2679513860 https://www.proquest.com/docview/2307393779 https://pubmed.ncbi.nlm.nih.gov/PMC6776289 https://doaj.org/article/92a88b9f26004708b8b873210b3ca5b0
Volume	14
WOSCitedRecordID	wos000489161200001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D
hasFullText	1
inHoldings	1
isFullTextHit
isPrint
journalDatabaseRights	– providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: DOA dateStart: 20090101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: M~E dateStart: 20060101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre – providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: 7X7 dateStart: 20140101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: BENPR dateStart: 20140101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Nursing & Allied Health Source customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: 7RV dateStart: 20140101 isFulltext: true titleUrlDefault: https://search.proquest.com/nahs providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Publicly Available Content Database customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: PIMPY dateStart: 20140101 isFulltext: true titleUrlDefault: http://search.proquest.com/publiccontent providerName: ProQuest – providerCode: PRVPQU databaseName: Public Health Database customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: 8C1 dateStart: 20140101 isFulltext: true titleUrlDefault: https://search.proquest.com/publichealth providerName: ProQuest – providerCode: PRVAWR databaseName: Taylor & Francis Open Access customDbUrl: eissn: 1178-2005 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0056771 issn: 1178-2005 databaseCode: 0YH dateStart: 20060101 isFulltext: true titleUrlDefault: https://www.tandfonline.com providerName: Taylor & Francis
link	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3db9MwED_BhhAvfMMCowQJtAcUFseJ7TyhrmwCiZVqFNQ9RbYTb5O2ZLQdfz93iVsWIXhBlSy1vlR27s53Z59_B_C6lMZaIeIok9pggKKzKHcyjzJrElZym-a2xZn9LMdjNZvlE7_htvBplas1sV2oy8bSHvluIiQ6A1yJ-P3lj4iqRtHpqi-hcRM2GdlulGd59H21EmdCdgEXkwKVOhZd4jtV5tkdfZl8ePcV1TXOWM8ktcj9f67P1wxUP3nymjU6uPe_87gPd70fGg47wXkAN6r6Idw-9Cftj2CH7oaE0yakw4NFFdJMwukqKz0cnp_gny5PLx7Dt4P96ehj5IsqRBZDjWWkGHOi4jw3TMkkMaxizgpXKsVZIrhTpUq0Q78lQ57FWldZbNArMSYtdWpyx5_ARt3U1RaEFT5lU7Syhgy9c9rx3KIDw12lZaZtAG9X77WwHnGcCl-cFxh5EBcKGnvhuRDAmzX1ZYe08Re6PWLRmobwsdsfmvlJ4dWtyBOtFI6W4PdTGSuDH0nXlQy3OjNxAC-JwUV32XSt5cVQxCmT6MNlAey0FKTnOGir_XUFnDohZvUot3uUqJ-2370ShMKvD4vitxQE8GrdTU9SzltdNVdIwzu4QpkH8LSTufWkObrRhOocgOxJY--t9Hvqs9MWPRyVQmCU_ezfw3oOd9A19Nl027CxnF9VL-CW_bk8W8wHrZpRO5Ntq7BVIzaAzb398eRo0O5s4LfJp8PJ8S_28TQ_
linkProvider	ProQuest
linkToHtml	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9QwEB6VgoAL70eg0CBR9YBCkzixnQNCS0vVqttSiUXam7Edu61UdsvuFsSf4jcykxeNENx6QLnFk2hsj7-ZSeYB8LIUxlrO4ygX2qCDovOo8KKIcmvSpGQ2K2xVZ3YoDg7keFwcLsHPNheGwipbTKyAupxa-ka-kXKBxgCTPH579jWirlH0d7VtoVGLxZ778R1dtvmb3S3c37U03X4_2tyJmq4CkUVbexHJJPHcMVaYRIo0NYlLvOW-lJIlKWdeljLVHhV3jkzHWrs8NqiWjclKnZnCM3zvFbiKOC4ohEyMOwcv56J28BLBEURiXgfaUyegjc0Ph1uvPyI8xHnSU4FVp4A_9cEFhdgP1ryg_bZv_2_rdgduNXZ2OKgPxl1YcpN7cH2_iSS4D-uU-xKOpiH9HJm7kFYuHLVR9-Hg9AgnsTj-8gA-XQqbD2F5Mp24xxA6fMpmaEUYMmS8154VFg005p0WubYBvGr3Udmmojo19jhV6FnRriviXTW7HsBaR31WVxL5C907EomOhup_VzemsyPVwIkqUi0lckvtBTIRS4OXoHQsw6zOTRzAKgmUqpNpOxRTAx5niUAbNQ9gvaIgHEOmrW7SMXDqVBGsR7nSo0T8sf3hVvBUg39z9VvqAnjRDdOTFNM3cdNzpGF1OUZRBPColvFu0gzdBKpaHYDoSX9vVfojk5Pjqjo6HkKeyuLJv9lahRs7o_2hGu4e7D2Fm2gGN5GDK7C8mJ27Z3DNfluczGfPqyMewufLPhu_AOrgifo
linkToPdf	http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9QwEB6VFlVceD8ChQaJqgcUNokT2zkgtO12RdWyrGCRejO2Y7eVSrbsbkH8NX4d48RZGiG49YByW0-isTOPbzbzAHhRMqU1pXGUM6kwQJF5VFhWRLlWaVISnRW67jN7yEYjfnRUjFfgZ1sL49IqW5tYG-pyqt1_5L2UMgQDhNO4Z31axHgwfHP-NXITpNyX1nacRiMiB-bHdwzf5q_3B_iut9J0uDfZfRv5CQORRty9iHiSWGoIKVTCWZqqxCRWU1tyTpKUEstLnkqLTjzHDcRSmjxW6KKVykqZqcISfO41WGMIMlC71nb2RuMPrR_IKWvCvYRRNCkxbdLu3Vyg3u778eDVRzQWcZ50HGI9N-BP73DJPXZTNy_5wuGt__kUb8NNj8DDfqMyd2DFVHdh_Z3PMbgH264qJpxMQ_fZZG5Cd4rhpM3HD_tnx7iJxcmX-_DpSth8AKvVtDKPIDR4l84QXygHcayVlhQaoRuxRrJc6gBetu9UaN9r3Y38OBMYczkJEI534SUggK0l9XnTY-QvdDtOPJY0rjN4_cN0diy8oRFFKjlHbt3ggYzFXOHFXKGWIlrmKg5g0wmXaMpsl_ZN9GmcJQzRax7Adk3hLBwyraUv1MCtu15hHcqNDiVaJt1dboVQeMs4F78lMIDny2V3p8v2q8z0AmlI06iRFQE8bOR9uWmCAYTrZx0A62hC51S6K9XpSd03HRWSprx4_G-2NmEdVUIc7o8OnsANxMc-pXADVhezC_MUrutvi9P57JnX9xA-X7Vy_AKl-JQb
openUrl	ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Time+To+Revise+COPD+Treatment+Algorithm&rft.jtitle=International+journal+of+chronic+obstructive+pulmonary+disease&rft.au=Matsunaga%2C+K&rft.au=Oishi%2C+K&rft.au=Miravitlles%2C+M&rft.au=Anzueto%2C+A&rft.date=2019-09-01&rft.pub=Dove+Medical+Press+Ltd&rft.issn=1176-9106&rft.eissn=1178-2005&rft.volume=14&rft.spage=2229&rft_id=info:doi/10.2147%2FCOPD.S219051&rft.externalDBID=HAS_PDF_LINK
thumbnail_l	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1178-2005&client=summon
thumbnail_m	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1178-2005&client=summon
thumbnail_s	http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1178-2005&client=summon