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Background: Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. Objectives: To evaluate the level of medical experts' consensus on their preferred first-choice treatment within different COPD categories. Methods: A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts. Results: Good consensus was reached by both expert groups for long-acting bronchodilators instead of short-acting bronchodilators as first-choice treatment in GOLD A. Single bronchodilation with long-acting muscarinic antagonist (LAMA) was preferred over long-acting beta 2-agonist (LABA) and LABA/LAMA as first-choice treatment in GOLD B and GOLD C. For GOLD D patients based on the forced expiratory volume in 1 second (FEV1), 50%, a very good consensus was reached for LAMA/LABA as first-choice treatment. For GOLD D patients based on frequent or severe exacerbations, there was a good consensus for LABA/LAMA/inhaled corticosteroids (ICS) as first choice in the Belgian group. According to the European experts, both LABA/LAMA and LABA/LAMA/ICS could be the first choice for these patients. Conclusion: Belgian and European experts recommend long-acting bronchodilators as first-choice treatment. Treatment containing ICS was found only appropriate in patients with FEV1,50% and $ 2 moderate exacerbations or 1 severe exacerbation/year.
Keywords
OBSTRUCTIVE PULMONARY-DISEASE, SALMETEROL-FLUTICASONE, PARALLEL-GROUP, REAL-LIFE, GUIDELINES, TIOTROPIUM, EXACERBATIONS, CLASSIFICATION, INDACATEROL, PREVENTION, chronic obstructive pulmonary disease, therapy, long acting muscarinic, antagonist, long acting beta agonist, inhaled corticosteroids, guidelines

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Chicago
Ninane, Vincent, Jean-Louis Corhay, Paul Germonpre, Wim Janssens, Guy Joos, Giuseppe Liistro, Walter Vincken, Sandra Gurdain, Evelyne Vanvlasselaer, and An Lehouck. 2017. “Inhaled Treatment of COPD : a Delphi Consensus Statement.” International Journal of Chronic Obstructive Pulmonary Disease 12: 793–801.
APA
Ninane, V., Corhay, J.-L., Germonpre, P., Janssens, W., Joos, G., Liistro, G., Vincken, W., et al. (2017). Inhaled treatment of COPD : a Delphi consensus statement. INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 12, 793–801.
Vancouver
1.
Ninane V, Corhay J-L, Germonpre P, Janssens W, Joos G, Liistro G, et al. Inhaled treatment of COPD : a Delphi consensus statement. INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. 2017;12:793–801.
MLA
Ninane, Vincent, Jean-Louis Corhay, Paul Germonpre, et al. “Inhaled Treatment of COPD : a Delphi Consensus Statement.” INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12 (2017): 793–801. Print.
@article{8537578,
  abstract     = {Background: Global Initiative for Chronic Obstructive Lung Disease (GOLD) global strategy (2015) provides guidance for the treatment of chronic obstructive pulmonary disease (COPD) with different first-choice options per GOLD category without specification. 
Objectives: To evaluate the level of medical experts' consensus on their preferred first-choice treatment within different COPD categories. 
Methods: A two-round Delphi Panel consisting of 15 questions was completed by Belgian pulmonologists (n=31) and European (n=10) COPD experts. 
Results: Good consensus was reached by both expert groups for long-acting bronchodilators instead of short-acting bronchodilators as first-choice treatment in GOLD A. Single bronchodilation with long-acting muscarinic antagonist (LAMA) was preferred over long-acting beta 2-agonist (LABA) and LABA/LAMA as first-choice treatment in GOLD B and GOLD C. For GOLD D patients based on the forced expiratory volume in 1 second (FEV1), 50\%, a very good consensus was reached for LAMA/LABA as first-choice treatment. For GOLD D patients based on frequent or severe exacerbations, there was a good consensus for LABA/LAMA/inhaled corticosteroids (ICS) as first choice in the Belgian group. According to the European experts, both LABA/LAMA and LABA/LAMA/ICS could be the first choice for these patients. 
Conclusion: Belgian and European experts recommend long-acting bronchodilators as first-choice treatment. Treatment containing ICS was found only appropriate in patients with FEV1,50\% and \$ 2 moderate exacerbations or 1 severe exacerbation/year.},
  author       = {Ninane, Vincent and Corhay, Jean-Louis and Germonpre, Paul and Janssens, Wim and Joos, Guy and Liistro, Giuseppe and Vincken, Walter and Gurdain, Sandra and Vanvlasselaer, Evelyne and Lehouck, An},
  issn         = {1178-2005},
  journal      = {INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE},
  language     = {eng},
  pages        = {793--801},
  title        = {Inhaled treatment of COPD : a Delphi consensus statement},
  url          = {http://dx.doi.org/10.2147/COPD.S125564},
  volume       = {12},
  year         = {2017},
}

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