The Curbsiders Internal Medicine Podcast6 Okt 2025

#500: COPD Update with Cyrus Askin

GOLD Updates, Novel Treatments, and Managing Comorbidities in COPD Care

Level up your COPD care with practical, evidence-based strategies. Learn how to confirm airflow obstruction with spirometry (and use LLN/Z-scores thoughtfully), stage patients with the A/B/E framework, and build treatment around long-acting bronchodilation—adding ICS selectively based on exacerbations and eosinophils. We’ll highlight the nonpharmacologic moves that change outcomes (smoking cessation, vaccination, pulmonary rehab, oxygen when indicated), when to reach for add-ons (azithromycin, roflumilast), how to approach chronic hypercapnia with home NIV, and what’s new (hello, ensifentrine). Pulmonologist and longtime Curbsiders member Dr. Cyrus Askin (@Askins_Razor ) returns to share real-world pearls for diagnosing, treating, and managing comorbidities in COPD.

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Show Segments

Intro
Case 1
Diagnostic Workup
Understanding the Ratio, LLN/Z-Scores, and Equity
Symptom abd Risk Staging (A/B/E)
Case 2
Foundational Care
Initial Inhaler Strategy
Progression & Hypercapnia: NIV & Adherence Counseling
Add-On Pharmacologic Options for Frequent Exacerbators
What’s New and Emerging
Comorbidities and When to Refer
Take-Home Points Recap
Plugs, CME, and Credits

Credits

Written and produced by Paul Wurtz MD. Show notes, cover art, and infographic also created by Paul Wurtz MD.

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Reviewer: Emi Okamoto MD
Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP
Technical Production: PodPaste
Guest: Cyrus Askin MD

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