Clinical characteristics of chronic bronchitic, emphysematous and ACOS phenotypes in COPD patients with frequent exacerbations

Cheng, Yusheng; Tu, Xin; Pan, Linlin; Lü, Shuai; Ming, Xing; Li, Linlin; Chen, Xingwu

doi:10.2147/copd.s140231

Cited by 12 publications

(9 citation statements)

References 41 publications

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“…Seemungal et al and Mackay et al, respectively reported COPD patients with ≥ three exacerbations (SGRQ-c, p < 0.001) and ≥ two exacerbations (CAT, p = 0.025) per year have significantly worse HRQoL [ 33 , 37 ]. Cheng et al also reported COPD frequent exacerbators have significantly worse HRQoL (mMRC, p < 0.001; CAT, p < 0.001) compared to non-frequent exacerbators [ 38 ]. Therefore, this explains the significantly worse HRQoL among our patients with AE.…”

Section: Discussionmentioning

confidence: 99%

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia – a cross-sectional study

Chai

Mos

et al. 2020

BMC Pulm Med

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Background The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients’ health-related quality of life (HRQoL) according to their COPD phenotypes. Methods This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George’s Respiratory Questionnaire for COPD (SGRQ-c). Results Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p < 0.001). There were significantly more patients with mMRC 2–4 among AE (68.6%) (p < 0.001), compared to those with ACO (38.5%) and NON-AE (16.7%). AE patients had significantly higher total CAT (p = 0.003; p < 0.001) and SGRQ-c (both p < 0.001) scores than those with ACO and NON-AE. Patients with ACO had significantly higher total CAT and SGRQ-c (both p < 0.001) scores than those with NON-AE. AE patients had significantly higher score in each item of CAT and component of SGRQ-c compared to those with NON-AE (all p < 0.001), and ACO [(p = 0.003–0.016; p = < 0.001–0.005) except CAT 1, 2 and 7. ACO patients had significantly higher score in each item of CAT and component of SGRQ-c (p = < 0.001–0.040; p < 0.001) except CAT 2 and activity components of SGRQ-c. Conclusions The HRQoL of COPD patients was significantly different across different COPD phenotypes. HRQoL was worst in AE, followed by ACO and NON-AE. This study supports phenotyping COPD patients based on their exacerbation frequency and COPD subtypes. The treatment of COPD should be personalised according to these two factors.

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Section: Discussionmentioning

confidence: 99%

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia – a cross-sectional study

Chai

Mos

et al. 2020

BMC Pulm Med

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“…(33,37) Cheng et al also reported COPD frequent exacerbators have signi cantly worse HRQoL (mMRC, p < 0.001; CAT, p < 0.001) compared to non-frequent exacerbators. (38) Therefore, this explains the signi cantly worse HRQoL among our patients with AE. Despite similar exacerbation frequency, our patients with ACO had signi cantly worse HRQoL than those with NON-AE which highlights that COPD subtypes can also affect the patients' HRQoL.…”

Section: Discussionmentioning

confidence: 82%

Clinical Phenotypes and Heath-Related Quality of Life of COPD Patients in a Rural Setting in Malaysia – A Cross-Sectional Study

Chai

Mos

et al. 2020

Preprint

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Background The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients’ health-related quality of life (HRQoL) according to their COPD phenotypes. Methods This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23 th January 2018 to 22 th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George's Respiratory Questionnaire for COPD (SGRQ-c). Results Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the COPD patients, 65.9% had exposure to biomass fuel. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p < 0.001). There were significantly more patients with mMRC 2 – 4 among AE (68.6%) (p < 0.001), compared to those with ACO (38.5%) and NON-AE (16.7%). AE patients had significantly higher total CAT (p = 0.003; p < 0.001) and SGRQ-c (both p < 0.001) scores than those with ACO and NON-AE. Patients with ACO also had significantly higher total CAT and SGRQ-c (both p < 0.001) scores than those with NON-AE. AE patients had significantly higher score in each item of CAT and component of SGRQ-c compared to those with NON-AE (all p < 0.001), and ACO [(p = 0.003 – 0.016; p = < 0.001 – 0.005) except CAT 1, 2 and 7. ACO patients had significantly higher score in each item of CAT and component of SGRQ-c (p = < 0.001 – 0.040; p < 0.001) except CAT 2 and activity components of SGRQ-c. Conclusions The HRQoL of COPD patients was significantly different across COPD phenotypes. HRQoL was worst in AE, followed by ACO and NON-AE. This study supports phenotyping COPD patients based on their exacerbation frequency and COPD subtypes. The treatment of COPD should be personalised according to these two factors.

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“…The Spanish COPD Guidelines 19 describe four clinical phenotypes: ( i ) non-exacerbators, ( ii ) ACO, ( iii ) frequent exacerbators with emphysema, and ( iv ) frequent exacerbators with CB. Several differential characteristics were similarly described in frequent exacerbators of both emphysema and CB phenotypes compared to those of infrequent exacerbators 20 .…”

Section: Copd Phenotypesmentioning

confidence: 84%

Chronic obstructive pulmonary disease in non-smokers - Is it a different phenotype?

Jindal¹

2018

Indian J Med Res

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Clinical characteristics of chronic bronchitic, emphysematous and ACOS phenotypes in COPD patients with frequent exacerbations

Cited by 12 publications

References 41 publications

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia – a cross-sectional study

Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia – a cross-sectional study

Clinical Phenotypes and Heath-Related Quality of Life of COPD Patients in a Rural Setting in Malaysia – A Cross-Sectional Study

Chronic obstructive pulmonary disease in non-smokers - Is it a different phenotype?

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