GOLD Report

The GOLD Report recommends the use of long-acting bronchodilators for COPD maintenance therapy1

  • The GOLD Report recommends using long-acting bronchodilators for applicable patients, including long-acting muscarinic antagonists (LAMAs), as a standard of care for COPD maintenance
  • Spirometry, symptoms, and exacerbation history are recommended to provide a more complete assessment and picture of disease status

GOLD does not endorse any specific treatments.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) was launched in 1997 in collaboration with the National Heart, Lung, and Blood Institute, the National Institutes of Health, USA, and the World Health Organization. The 2017 GOLD Report was shaped by committees made up of leading experts from around the world. Working with health care professionals and public health officials, GOLD seeks to raise awareness and improve prevention and treatment of COPD. 


COPD severity informs the selection of maintenance therapy

GOLD classifies COPD severity in groups from A to D, based on parameters that include exacerbation history and symptom severity.1

According to GOLD, COPD patients in several classes may benefit from a long-acting bronchodilator for maintenance therapy1

GOLD Report - Patient classification for COPD Severity

GOLD Report - Patient classification for COPD Severity

*CAT is the intellectual property of GlaxoSmithKline. Not validated for US-based physicians. 

© 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD. All rights reserved. Use is by express license from the owner.

GOLD does not endorse any specific treatments.

Determination of an appropriate long-acting bronchodilator is based on symptom control.

COPD=chronic obstructive pulmonary disease; FEV1=forced expiratory volume in 1 second; 
FVC=forced vital capacity; mMRC=modified British Medical Research Council Questionnaire. 

COPD=chronic obstructive pulmonary disease; FEV1=forced expiratory volume in 1 second;  FVC=forced vital capacity; mMRC=modified British Medical Research Council Questionnaire. 


Assess risk of COPD exacerbations according to GOLD classification or exacerbation history1

Once symptom severity and risk are determined, the GOLD model can help guide appropriate pharmacological maintenance selection.

Highlighted boxes and arrows indicate GOLD-preferred treatment pathways.

GOLD Report - GOLD-preferred treatment pathways

GOLD Report - GOLD-preferred treatment pathways

In patients with a major discrepancy between the perceived level of symptoms and severity of airflow limitation, further evaluation is warranted.

© 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD. All rights reserved. Use is by express license from the owner.

For Group A, the maintenance bronchodilator can be short-acting or long-acting. A maintenance bronchodilator does not replace rescue medication.

GOLD does not endorse any specific treatments.

LABA=long-acting beta2-adrenergic agonist; ICS=inhaled corticosteroid.


Reference:
1. Global strategy for the diagnosis, management and prevention of COPD: 2017 report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2017:1-123.

Important Safety Information & Indication

Important Safety Information
 

LONHALA MAGNAIR is contraindicated in patients with a hypersensitivity to glycopyrrolate or to any of the ingredients.

LONHALA MAGNAIR should not be initiated in patients with acutely deteriorating or potentially life-threatening episodes of COPD or used as rescue therapy for acute episodes of bronchospasm. Acute symptoms should be treated with an inhaled short-acting beta2-agonist.

As with other inhaled medicines, LONHALA MAGNAIR can produce paradoxical bronchospasm that may be life-threatening. If paradoxical bronchospasm occurs following dosing with LONHALA MAGNAIR, it should be treated immediately with an inhaled, short-acting bronchodilator; LONHALA MAGNAIR should be discontinued immediately and alternative therapy instituted.

Immediate hypersensitivity reactions have been reported with LONHALA MAGNAIR. If signs occur, discontinue LONHALA MAGNAIR immediately and institute alternative therapy.

LONHALA MAGNAIR should be used with caution in patients with narrow-angle glaucoma and in patients with urinary retention. Prescribers and patients should be alert for signs and symptoms of acute narrow-angle glaucoma (e.g., eye pain or discomfort, blurred vision, visual halos or colored images in association with red eyes from conjunctival congestion and corneal edema) and of urinary retention (e.g., difficulty passing urine, painful urination), especially in patients with prostatic hyperplasia or bladder-neck obstruction. Patients should be instructed to consult a physician immediately should any of these signs or symptoms develop.

The most common adverse events reported in ≥2% of patients taking LONHALA MAGNAIR, and occurring more frequently than in patients taking placebo, were dyspnea (4.9% vs 3.0%) and urinary tract infection (2.1% vs 1.4%).

LONHALA solution is for oral inhalation only and should not be injected or swallowed. LONHALA vials should only be administered with MAGNAIR.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

For additional information, please see full Prescribing Information and Patient Information for LONHALA MAGNAIR at www.sunovionprofile.com/lonhala-magnair.

Indication
 

LONHALA™ MAGNAIR™ (glycopyrrolate) is an anticholinergic indicated for the long-term maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and/or emphysema.