Characteristics of COPD Phenotypes in Serbia

Abstract

Background Establishing a regional/national/international registry of patients suffering from chronic obstructive pulmonary disease (COPD) is essential for both research and healthcare, because it enables collection of comprehensive real-life data from a large number of individuals. Objective The aim of this study was to describe characteristics of COPD patients from the Serbian patient registry, and to investigate actual differences of those characteristics among the COPD phenotypes. Methods The Serbian registry of patients with COPD was established in 2018 at University of Kragujevac, Faculty of Medical Sciences, based on an online platform. Entry in the Registry was allowed for patients who were diagnosed with COPD according to the following criteria: symptoms of dyspnea, chronic cough or sputum production, history of risk factors for COPD and any degree of persistent airflow limitation diagnosed at spirometry. Results In the Serbian COPD registry B and D GOLD group were dominant, while among the COPD phenotypes, the most prevalent were non-exacerbators (49.4%) and then frequent exacerbators without chronic bronchitis (29.6%). The frequent exacerbator with chronic bronchitis phenotype was associated with low levels of bronchopulmonary function and absolute predominance of GOLD D group. Anxiety, depression, insomnia, hypertension and chronic heart failure were the most prevalent in the frequent exacerbator with chronic bronchitis phenotype; patients with this phenotype were also treated more frequently than other patients with a triple combination of the most effective inhaled anti-obstructive drugs: long-acting muscarinic antagonists, long-acting beta 2 agonists and corticosteroids. Conclusion In conclusion, the data from the Serbian registry are in line with those from other national registries, showing that frequent exacerbators with chronic bronchitis have worse bronchopulmonary function, more severe signs and symptoms, and more comorbidities (especially anxiety and depression) than other phenotypes. Other studies also confirmed worse quality of life and worse prognosis of the AE-CB phenotype, stressing importance of both preventive and appropriate therapeutic measures against chronic bronchitis.

Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study

“…By contrast, 29.1% of patients with ACO were not receiving ICS, despite the benefits that ICS has demonstrated in this group of patients. Similarly, in other countries, it has been observed that treatment patterns differ among the phenotypes and ICS has not been used as widely as expected in the ACO phenotype [ 14 , 16 , 17 ].…”

Chronic Obstructive Pulmonary Disease in Can Tho: Clinical Characteristics and Features of Treatment by Clinical Phenotypes

“…There have been many studies evaluating the prevalence of COPD phenotypes, most of these studies have a larger proportion of NON-AE phenotypes than the remaining phenotypes. Research by author Lazic in 2020 in Serbia [8] showed the proportion of ACO, NON-AE, AE-CB and AE-NON-CB phenotypes, respectively, 8.7%, 49.3%, 12.3%, and 29.7%. We found that patients with AE phenotypes accounted for a higher proportion than the remaining phenotypes.…”

“…The estimated sample size for the study was 124 based on the proportion of patients with the ACO phenotype of 8.8 % (ACO accounted for the lowest of the four phenotypes) in a 2016 study in Serbia by Zorica Lazic et al, with a class I error of 5% and an accuracy of 5% [8]. The attrition rate (dropout or loss to follow-up) was expected to be about 25%.…”

The Effects of Antidepressant Therapy on Health-Related Quality of Life in Patients with a Chronic Obstructive Pulmonary Disease and Depressive Symptoms

“…COPD adversely affects the quality of life of patients, decreasing the number of Disability Adjusted Life Years (DALY) one can get during lifetime [2]. A number of countries organized national registries of COPD patients, showing a relatively high prevalence of this disease, which ranges between 4 and 5% [3][4][5]. Numerous factors contribute to the development of COPD.…”