CHEST COPD Immersion June 2025-3. Updated GOLD 2025 Report

3. Updated GOLD 2025 Report

Pdf Summary

The updated 2025 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report provides several key updates relevant to clinicians managing COPD. It emphasizes the impact of climate change on COPD, citing how extreme temperatures and air pollution can exacerbate patient health. Optimal indoor conditions are recommended as 18°C during cold spells and 24°C during heatwaves.<br /><br />A shift in diagnosing COPD through pre-bronchodilator spirometry is highlighted, with GOLD favoring the fixed ratio approach for its diagnostic simplicity, though noting potential underdiagnosis in younger patients and overdiagnosis in the elderly.<br /><br />Early identification through case-finding strategies is encouraged, which involve active and opportunistic methods, such as screening during lung cancer checks. The role of CT scans in clinics is noted for its usefulness in phenotyping patients by assessing emphysema and airway disease.<br /><br />The report underscores the linkage between COPD and cardiovascular diseases, urging more attention to these comorbidities, which often remain underrecognized. There is a particular focus on pulmonary hypertension, recommending a differentiated treatment approach based on various patterns of the disease.<br /><br />New therapeutic options, including biologics like dupilumab and ensifentrine, are discussed. These are proposed for certain subgroups of COPD patients, reflecting an emphasis on personalized medicine. Guidelines on initiating and withdrawing inhaled corticosteroids (ICS) are updated, recommending avoidance in cases with certain blood cell counts due to exacerbation risks.<br /><br />Telehealth's role in COPD management has become more prominent post-COVID-19, with GOLD 2025 promoting tele-rehabilitation, education, and self-management, while urging careful application based on evidence.<br /><br />Lastly, there is a strong focus on enhancing early diagnosis, managing comorbidities, implementing vaccination schemes, and using telehealth effectively. These updates may challenge clinicians, particularly in primary care, requiring adaptation to align with local practices.

Keywords

COPD

Chronic Obstructive Pulmonary Disease

GOLD 2025

climate change

spirometry

case-finding

cardiovascular comorbidities

pulmonary hypertension

biologics

telehealth

personalized medicine