Optimum treatment for chronic obstructive pulmonary disease exacerbation prevention

An exacerbation of chronic obstructive pulmonary disease (COPD) is defined as an acute worsening of symptoms greater than the usual day to day variation that requires increased pharmacotherapy (1). Some COPD patients suffer with exacerbations regularly, and the history of previous exacerbations is the best predictor for the risk of future exacerbations (2). The Global initiative for chronic Obstructive Lung Disease (GOLD) uses a threshold of ≥ two exacerbations or one hospitalization in the last year to identify patients with an increased risk of future exacerbations (3).