2027 GOLD COPD Report Updates: Àlvar Agustí

The 2027 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report includes a completely revised rehabilitation chapter, a reworked cardiovascular section, and changes to some initial treatment recommendations for chronic obstructive pulmonary disease (COPD), according to Àlvar Agustí, MD, PhD, professor of medicine at the University of Barcelona, senior consultant at Hospital Clinic, Barcelona, and chair of the GOLD board of directors.

In an interview with The American Journal of Managed Care^®, Agustí discussed what is new in the 2027 report, the volume of research behind each annual update, and the case for a new narrative on COPD.

What Changed in the 2027 GOLD Report

Updating the report every year is a major undertaking, Agustí said, yet the process keeps turning up findings that justify changes. This edition adds some new material along with a revised chapter. “For instance, the rehabilitation chapter has been completely revised,” Agustí said.

The cardiovascular section also received a full review. Agustí explained that the GOLD committee has recognized over the past few years that cardiovascular risk is a concern after an exacerbation, so the section was rewritten with input from cardiologists. Those specialists “know much more than we do on cardiovascular issues,” Agustí said.

Agustí added that some of the initial treatment recommendations from the previous edition have been changed. “There are many things,” Agustí said, and recommended that interested physicians read the report to learn more.

How the Committee Reviews the Evidence

Research on COPD is under way around the world, according to Agustí. Last year, the GOLD Science Committee reviewed approximately 3000 papers and selected about 100 that provided new data. Agustí described the annual workload as enormous but said the committee embraces it. “We do it, and we are happy to do it,” Agustí said.

Why COPD Needs a New Narrative

Agustí noted that COPD has traditionally been viewed as a self-inflicted disease caused by smoking in older men. That view is partially correct and partially incorrect, Agustí said. The condition can result from factors other than smoking, it occurs in women as well as men, and it can affect younger people, not only older adults.

Because of these shifts, Agustí said, a new narrative is needed. A paper calling for action on diagnosis, characterization, and gender differences in COPD is being presented. It is not part of the GOLD guidelines because it is not a guideline, Agustí explained. The GOLD recommendations are based on current evidence, while the new paper has a different aim. “It is looking into the future. What do we need to know?” Agustí said.

Agustí said the authors hope the paper will be published soon in several international journals.