Approaches to drug therapy for COPD in Russia: a proposed therapeutic algorithm

Figures & data

Table 1 Drug combinations used for the treatment of patients with COPD

Patient characteristics	First choice	Alternative choice
Low risk, less symptoms	SAMA as needed or SABA as needed	LAMA or LABA or SABA and SAMA
Low risk, more symptoms	LAMA or LABA	LAMA and LABA
High risk, less symptoms	ICSs + LABA or LAMA	LAMA and LABA or LAMA and PDE4 inhibitor or LABA and PDE4 inhibitor
High risk, more symptoms	ICSs + LABA and/or LAMA	ICSs + LABA and LAMA or ICSs + LABA and PDE4 inhibitor or LAMA and LABA or LAMA and PDE4 inhibitor

Note: Data from Federal clinical recommendations for diagnostics and treatment of chronic obstructive pulmonary disease. Russian Respiratory Society; 2014.¹²

Abbreviations: ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LAMA, long-acting muscarinic antagonist; PDE4, phosphodiesterase-4; SABA, short-acting beta-agonist; SAMA, short-acting muscarinic antagonist.

Figure 1 The proposed algorithm for the management of patients with stable COPD.

Notes: *Evaluation of symptoms is based on the CAT questionnaire, if there was more than one clinical exacerbation or one clinical event leading to hospitalization during one year of follow-up. **Pathophysiological endotyping: 1) eosinophilic endotype with peripheral blood eosinophilia or sputum eosinophilia >3%; 2) neutrophilic endotype with peripheral blood neutrophilia of >60% or with green sputum; or 3) pauci-granulocytic endotype.
Abbreviations: CAT, COPD assessment test; FEV₁, forced expiratory volume in one second; GPs, general physicians; ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LAMA, long-acting muscarinic antagonist; SABA, short-acting beta-agonist; SAMA, short-acting muscarinic antagonist.

Federal clinical recommendations for diagnostics and treatment of chronic obstructive pulmonary diseaseRussian Respiratory Society2014 Available from: http://pulmonology.ru/download/COPD2014may2.docAccessed February 9, 2017 Russian

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