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KMID : 1141720190070010021
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폐쇄성폐질환
2019 Volume.7 No. 1 p.21 ~ p.24
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Debate on the Positioning of ICS as the First Combination Option in Group D of COPD: Pro
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Lee Chang-Hoon
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Abstract
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GOLD group D includes symptomatic COPD patients at high risk, who are the major target group requiring adequate treatment. The current GOLD guideline recommends a combined therapy with LABA and LAMA. However, recent large clinical trials showed different results. I reviewed the recent trials and conducted meta-analysis regarding the efficacy and safety between LABA/LAMA therapy and ICS-containing therapies including ICS/LABA/LAMA and ICS/LABA especially in group D COPD patients. ICS/LABA/LAMA and ICS/LABA treatment had better efficacy in reducing exacerbation risk and mortality than LABA/LAMA therapy. ICS-containing therapy increased the risk of pneumonia, however, the benefits coudl offset the harmful effects. This review favor the ICS-containing combination therapy should be considered as the first line therapy for group D COPD patients.
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KEYWORD
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GOLD, Group D, COPD, ICS, LABA, LAMA
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