Global Initiative for Chronic Obstructive Lung Disease (GOLD) Revisions 2001-2017: Historical and Critical Perspective
Claus Vogelmeier 1, Gerard J. Criner 2, Fernando J. Martinez 3
1 Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-Universität Marburg, Member of the German Centre for Lung Research (DZL), Marburg, Germany; 2 Temple Lung Center, Temple University School of Medicine, Philadelphia, USA; 3 Division of Pulmonary and Critical Care Medicine, and Department of Genetic Medicine, Weill Cornell Medicine, New York, NY, USA
*Correspondence: Claus Vogelmeier, Email not available
Abstract
In 2001, the first Global Initiative for Chronic Obstructive Lung Disease (GOLD) document was published with the goal to improve the diagnosis, prevention and treatment of chronic obstructive pulmonary disease (COPD). Since then, three major revisions (GOLD 2007, 2011 and 2017) have been released. In this review, we describe the basic principles of the first document and how it has evolved over time. Initially, assessment was based exclusively on the level of airflow limitation. Nowadays, airflow limitation, respiratory symptom load and exacerbation history are taken into account. Bronchodilators have always been first-line. However, the indication for inhaled corticosteroids (ICS) has evolved over time. Non-pharmacological therapies are now considered to be of equal importance. In the latest version, interventional methods, palliative care, and end-of-life strategies have been added. The prevention and adequate treatment of exacerbations are highlighted and an expanded discussion of comorbidities has been added.
