Question 1

What changed in GOLD 2023 A/B/E classification?

Accepted Answer

Groups C and D were merged into Group E (high exacerbation risk), simplifying treatment. Group A is low symptoms/low exacerbations, B is more symptoms/low risk, E is high exacerbation risk.

Question 2

How are blood eosinophils used in treatment decisions?

Accepted Answer

ICS is recommended for eosinophils at least 300 cells/uL. For 100-299, ICS may be considered case-by-case. Below 100, ICS adds little benefit and may increase pneumonia risk.

Question 3

What are the indications for triple therapy?

Accepted Answer

Triple therapy is indicated for GOLD Group E patients who continue to exacerbate despite LAMA/LABA, particularly with eosinophils at least 300. It reduces exacerbations by 15-25%.

Question 4

How often should spirometry be reassessed?

Accepted Answer

Spirometry should be repeated at least annually. The GOLD group should be reassessed at every clinical encounter based on current symptoms and exacerbation history.