COPD - is one exacerbation enough?

• Published in: African journal of thoracic and critical care medicine Vol. 29; no. 3; p. 142
• Main Author: van den Berg, A J
• Format: Journal Article
• Language: English
• Published: South African Medical Association NPC 01.09.2023; South African Medical Association
• ISSN: 2617-0191; 2617-0205
• DOI: 10.10520/ejc-m_ajtccm_v29_n3_a12

Chronic obstructive pulmonary disease (COPD) remains one of the most prevalent pulmonary diseases worldwide, causing significant morbidity and mortality. The recent GOLD guidelines have changed the classification of COPD from the previous ABCD system to an ABE classification, with the E category representing those with one severe exacerbation, or two or more moderate exacerbations.[1] This is a clinically important threshold, as patients with category E disease are commonly given inhaled corticosteroid (ICS) therapy, while it is often withheld from category A and B patients. With the goal of examining the validity of this threshold, Vanfleteren and colleagues[2] have recently published a nationwide cohort study based on over 45 000 patients in the Swedish National Airway Register. They divided the patients into the GOLD groups and added a 0 or a 1 for category A and B patients, with a 1 indicating that a patient had a prior moderate exacerbation and 0, none. The groups were followed up and exacerbation rates, hospitalisation, and mortality compared.