title: The clinical management of COPD exacerbations: an update.
abstract: Clinical management of chronic obstructive pulmonary disease (COPD) exacerbations is of high importance because exacerbations reduce quality of life, increase mortality and carry high socioeconomic costs. Still, a quarter of patients with an acute exacerbation do not respond adequately to initial exacerbation treatment. Yet, research from recent years has advanced the clinical management of COPD exacerbations. Prediction of exacerbations can be improved by asking patients about their exacerbation history. The duration of oral corticosteroid treatment has been optimized, new oral- and inhalation medication has become available and important knowledge has been gathered about the risks and benefits of inhalation corticosteroids, which we will discuss in this editorial. Still, future research is needed to tailor treatment strategies for specific COPD phenotypes.
authors.affiliation: a Department of Pulmonology , Leiden University Medical Center , Leiden , the Netherlands.
authors.forename: Tobias N
authors.initials: TN
authors.lastname: Bonten
authors.affiliation: a Department of Pulmonology , Leiden University Medical Center , Leiden , the Netherlands.
authors.forename: Marise J
authors.initials: MJ
authors.lastname: Kasteleyn
authors.affiliation: a Department of Pulmonology , Leiden University Medical Center , Leiden , the Netherlands.
authors.forename: Christian
authors.initials: C
authors.lastname: Taube
authors.affiliation: b Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , the Netherlands.
authors.forename: Niels H
authors.initials: NH
authors.lastname: Chavannes
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life
chemical_list: D005938:Glucocorticoids
keywords: Chronic obstructie pulmonary disease; LABA; LAMA; asthma COPD overlap syndrome; disease management; exacerbation; glucocorticoids; prediction; roflumilast; vitamin D