Prospective Assessment Of Global Initiative For Chronic Obstructive Lung Disease (gold) 2017 Categories And Chronic Obstructive Pulmonary Disease (COPD) Phenotypes: Evolution During Two Years

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27661989%3A_____%2F17%3AN0000017" target="_blank" >RIV/27661989:_____/17:N0000017 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A7712?role=tab" target="_blank" >https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2017.195.1_MeetingAbstracts.A7712?role=tab</a>

DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Prospective Assessment Of Global Initiative For Chronic Obstructive Lung Disease (gold) 2017 Categories And Chronic Obstructive Pulmonary Disease (COPD) Phenotypes: Evolution During Two Years

Popis výsledku v původním jazyce

RATIONALE: Currently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) released a revised consensus report (GOLD 2017) which refined ABCD classification of chronic obstructive pulmonary disease (COPD) patients. Moreover, some authors proposed subsequent grouping of COPD subjects into clinically meaningful phenotypes. The real-life evolution of GOLD 2017 categories (A-D) and clinical phenotypes during prospective follow-up remains largely unknown. METHODS: Prospective observational data from the Czech Research Database of COPD (CMRD) were used to compare time changes of GOLD categories with the same parameter of elementary clinical COPD phenotypes. Subjects with severe COPD (FEV₁ <60%) enrolled in GOLD categories with the same parameter of elementary clinical COPD phenotypes. This multicentric project were assessed annually during two years (i.e. three times). We used the old (2016) and new (2017) definition of ABCD categories. Above that, patients were stratified according to predefined clinical phenotypes as: non-exacerbators (NON-AE), asthma/COPD overlap syndrome (ACOS), frequent exacerbators with chronic bronchitis (AE-CB) and without chronic bronchitis (AE NON-CB). We used two different approach to evaluation. Firstly, we compared stable versus non-stable categories/phenotypes. Secondly, we compared stable versus non-stable better than baseline versus non-stable than baseline categories/phenotypes. RESULTS: 784 COPD individuals (66 yrs, 73% males, post-BD FEV₁ 45±11.6%) were enrolled until Dec 2016. 292 of them were eligible for two-year analysis. Old and new GOLD classification spectrum consisted of A 5%, B 20%, C 5%, D 70% (GOLD 2016), respectively A 8%, B 53%, C 2%, D 37% (GOLD 2017) categories. Sixty-two % of the population were NON-AE, 18% were AE CB, 8% were AE NON-CB, and 12% were ACOS subjects. Stability to non-stability rates of both GOLD versions significantly (p<0.01) differed from stability to non-stability pattern of clinical phenotypes. Sixty-five % of the GOLD 2016 categories, 61% of the GOLD 2016 categories, and 44% of GOLD 2017 categories remained stable in the three consecutive evaluations (table 1). Apparent differences among GOLD 2016, GOLD 2017, and phenotypes stability during 2 years follow-up were observed. The most stable (ACOS, NON-AE, GOLD D 2016, GOLD B 2017) and unstable above mentioned subgroups in the Czech national cohort of severe COPD subjects. CONCLUSION: Our study suggests that COPD phenotypes more stable patients’ attribute than GOLD categories. The worst stability was observed in case of GOLD 2017 version, only 44% of these categories were identical during long-term evaluation. These findings brings real-world evidence for heterogeneity description of this serious condition.

Název v anglickém jazyce

Prospective Assessment Of Global Initiative For Chronic Obstructive Lung Disease (gold) 2017 Categories And Chronic Obstructive Pulmonary Disease (COPD) Phenotypes: Evolution During Two Years

Popis výsledku anglicky

RATIONALE: Currently, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) released a revised consensus report (GOLD 2017) which refined ABCD classification of chronic obstructive pulmonary disease (COPD) patients. Moreover, some authors proposed subsequent grouping of COPD subjects into clinically meaningful phenotypes. The real-life evolution of GOLD 2017 categories (A-D) and clinical phenotypes during prospective follow-up remains largely unknown. METHODS: Prospective observational data from the Czech Research Database of COPD (CMRD) were used to compare time changes of GOLD categories with the same parameter of elementary clinical COPD phenotypes. Subjects with severe COPD (FEV₁ <60%) enrolled in GOLD categories with the same parameter of elementary clinical COPD phenotypes. This multicentric project were assessed annually during two years (i.e. three times). We used the old (2016) and new (2017) definition of ABCD categories. Above that, patients were stratified according to predefined clinical phenotypes as: non-exacerbators (NON-AE), asthma/COPD overlap syndrome (ACOS), frequent exacerbators with chronic bronchitis (AE-CB) and without chronic bronchitis (AE NON-CB). We used two different approach to evaluation. Firstly, we compared stable versus non-stable categories/phenotypes. Secondly, we compared stable versus non-stable better than baseline versus non-stable than baseline categories/phenotypes. RESULTS: 784 COPD individuals (66 yrs, 73% males, post-BD FEV₁ 45±11.6%) were enrolled until Dec 2016. 292 of them were eligible for two-year analysis. Old and new GOLD classification spectrum consisted of A 5%, B 20%, C 5%, D 70% (GOLD 2016), respectively A 8%, B 53%, C 2%, D 37% (GOLD 2017) categories. Sixty-two % of the population were NON-AE, 18% were AE CB, 8% were AE NON-CB, and 12% were ACOS subjects. Stability to non-stability rates of both GOLD versions significantly (p<0.01) differed from stability to non-stability pattern of clinical phenotypes. Sixty-five % of the GOLD 2016 categories, 61% of the GOLD 2016 categories, and 44% of GOLD 2017 categories remained stable in the three consecutive evaluations (table 1). Apparent differences among GOLD 2016, GOLD 2017, and phenotypes stability during 2 years follow-up were observed. The most stable (ACOS, NON-AE, GOLD D 2016, GOLD B 2017) and unstable above mentioned subgroups in the Czech national cohort of severe COPD subjects. CONCLUSION: Our study suggests that COPD phenotypes more stable patients’ attribute than GOLD categories. The worst stability was observed in case of GOLD 2017 version, only 44% of these categories were identical during long-term evaluation. These findings brings real-world evidence for heterogeneity description of this serious condition.

Druh

J_ost - Ostatní články v recenzovaných periodicích

CEP obor

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OECD FORD obor

30200 - Clinical medicine

Projekt

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Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

American Journal of Respiratory and Critical Care Medicine

ISSN

1073-449X

e-ISSN

1535-4970

Svazek periodika

195

Číslo periodika v rámci svazku

B49

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

1

Strana od-do

A7712

Kód UT WoS článku

000400372507812

EID výsledku v databázi Scopus

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