A two-year evaluation of the ‘real life’ impact of COPD on patients in Germany: The DACCORD observational study

Abstract

Overall, the 2-year follow-up data from DACCORD suggest that for most patients with COPD exacerbations are a rare event. For the majority of patients, the focus should be on managing symptoms, and the impact that these symptoms have on their daily lives. Even for those patients who do exacerbate, although prevention of exacerbations is an important factor, management of symptoms should be a key consideration. DACCORD also suggests that COPD disease progression is not inevitable - providing patients are receiving pharmacological treatment.

Chronic obstructive pulmonary disease with mild airflow limitation: current knowledge and proposal for future research – a consensus document from six scientific societies

“…In fact, on one hand, airflow limitation, even mild, can unduly limit the patient’s physical activity; 14 , 15 on the other hand, particularly in younger subjects, mild airflow limitation might coincide with the early stage of the disease. 16 , 17 In this connection, it is worthy of note that the mean age of COPD patients does not differ very much among stages, from mild to severe and very severe, in large trials 18 or observational 19 , 20 and physiologic studies. 21 , 22 This suggests that in some subjects, mild airflow limitation might be the only physiologic phenotype of the disease, while in others it could represent the first stage toward a progressive deterioration in lung function.…”

“…However, the ECLIPSE study 18 reported that the majority of COPD patients with moderate–severe airflow limitation were not frequent exacerbators. In fact, the 2-year follow-up data from the DACCORD study 20 showed that in a population of COPD patients with a low rate of exacerbation (<0.4 exacerbations/year), respiratory symptoms were a common cause for seeking medical help and should not be underestimated, as a significant improvement can be obtained with pharmacologic treatment. In the DACCORD population, almost 20% had mild airflow limitation.…”

“…In the DACCORD population, almost 20% had mild airflow limitation. 20 In the longitudinal results from the COPDGene study 47 48 of 185 COPD patients classified as GOLD 1 were receiving pharmacologic treatment with long-acting bronchodilators and/or inhaled corticosteroids at the 5-year visit.…”

COPD Treatment in Real Life and Randomized Controlled Trials: Is There Any Difference between Both Settings?

“…The "A two-year evaluation of the 'real life' impact of COPD on patients in Germany: The DACCORD observational study" published in Respiratory Medicine 2017 [5] will add to fill the gaps of RCT's and register studies. DACCORD (Die ambulante Versorgung mit langwirksamen Bronchodilatatoren: COPD Register in Deutschland, English translation: Outpatient Care with Long-Acting Bronchodilators: COPD Registry in Germany) is an ongoing observational, non-interventional study being conducted in almost 500 German primary and secondary care centres.…”

A Non-Interventional Study of Tiotropium/Olodaterol versus Any Triple Combination Therapy for Chronic Obstructive Pulmonary Disease: The EVELUT® Study Protocol

“…In Germany, almost two-thirds of patients with COPD receive ICS; however, only a small subpopulation of these patients exacerbates, indicating that ICS may currently be routinely prescribed even in the absence of frequent exacerbations. 13 , 14 EVELUT will investigate the comparative effectiveness of tio/olo LAMA/LABA therapy versus any triple therapy in dyspneic patients switching from LABA/ICS as maintenance therapy, as per their treating physician’s recommendation. The results of the EVELUT study are expected to generate further evidence to help address a key question physicians face daily in clinical practice, namely should a symptomatic patient on LABA/ICS maintenance therapy be switched to LAMA/LABA or LAMA/LABA/ICS?…”