Goals of COPD treatment: Focus on symptoms and exacerbations.

Chronic obstructive pulmonary disease (COPD) is currently a leading cause of death worldwide, and its burden is expected to rise in the coming years. Common COPD symptoms include dyspnea, cough and/or sputum production. Some patients may experience acute worsening of symptoms (known as an exacerbation), and therefore require additional therapy. Exacerbations are mainly triggered by respiratory infections and environmental factors. Healthcare professionals face many challenges in COPD management, including the heterogeneity of the disease and under-reporting of symptoms. The authors review these challenges and provide recommendations for the best methods to assess COPD. The goals of COPD treatment include recognising the impact that both symptoms and exacerbations have on patients' lives when considering optimal patient-focused management. The review discusses the need for COPD management strategies to include both pharmacologic and non-pharmacologic approaches and provides recommendations for monitoring treatment outcomes and adjusting management strategies accordingly. Novel treatment strategies including precision medicine and point-of-care testing are also discussed.

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Déclaration de conflit d'intérêts

Declaration of competing interest CFV reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Grifols, Mundipharma and Novartis, personal fees from Berlin Chemie/Menarini, CSL Behring, Nuvaira and Teva, and grants from the German Federal Ministry of Education and Research (BMBF) Competence Network Asthma and COPD (ASCONET), outside the submitted work. MR-R reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Menarini, Mundipharma, Novartis, Pfizer, Teva and Bial, and grants and personal fees from GlaxoSmithKline, outside the submitted work. DS reports personal fees from Apellis, Cipla, Genentech, Peptinnovate and Skyepharma, and grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Glenmark, Merck, Mundipharma, Novartis, Pfizer, Pulmatrix, Teva, Theravance and Verona, outside the submitted work. MKH reports personal fees from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Boehringer Ingelheim and Mylan, and other from Novartis and Sunovion, outside the submitted work. RR-R has nothing to disclose. GTF reports grants, personal fees and non-financial support from Boehringer Ingelheim, during the conduct of the study; grants, personal fees and non-financial support from Boehringer Ingelheim, Novartis, AstraZeneca, Pearl Therapeutics and Sunovion; personal fees from Verona, Mylan, Innoviva, GlaxoSmithKline and Circassia; and grants and personal fees from Theravance, outside the submitted work.