Clinical Phenotypes of COPD: Identification, Definition and Implications for Guidelines

Miravitlles, Marc; Calle, Myriam; Soler-Cataluña, Juan José

doi:10.1016/j.arbr.2012.01.003

Cited by 136 publications

(94 citation statements)

References 151 publications

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“…Данные фенотипы характери-зуют различия между пациентами, страдающими ХОБЛ, связанные с клинически значимыми прояв-лениями и важными исходами заболевания. При этом различия в выраженности прогрессирования заболевания у пациентов с этими фенотипами вы-явлены не были [3,32,44]. В 2012 году испанское общество пульмонологов и торакальных хирургов усовершенствовало классификацию с использова-нием фенотипов, добавив рекомендации по уче-ту частоты обострений.…”

Section: клинико-анамнестические критерии прогрессирующего течения хоблunclassified

Difficulty of Copd Predicting as a Challenge to Modern Clinical Pulmonology

et al. 2016

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РезюмеВ последние годы современное медицинское сообщество пришло к выводу, что применяемые в настоящее время прогностические критерии течения ХОБЛ не позволяют с высокой достоверностью предсказать дальнейшее развитие заболевания, его осложнения и исходы. Наи-более востребованным прогностическим критерием в клинической практике по-прежнему остается определение уровня ОФВ 1 . Однако на-коплена достаточная доказательная база, делающая необходимым расширение списка критериев для определения более точного прогноза течения и клинического исхода заболевания. Ведущей задачей современной пульмонологии, становится поиск прогностических маркеров, комплекса нескольких параметров, способных обеспечить прогноз и своевременный выбор терапии. Одними из них могут стать наличие у больных ХОБЛ коморбидных заболеваний и высокой частоты обострений. Ключевые слова: ХОБЛ, прогностические критерии, ОФВ 1 , обострения, коморбидные заболевания. AbstractIn recent years, medical community has come to the conclusion that the currently used prognostic criteria of the course of COPD, do not allow to predict the further development of the disease, its complications and outcomes with high accuracy. The most popular predictor in clinical practice remains the determination of the level of FEV1. However, the need to expand the list of criteria for determination of a more precise prognosis and clinical outcome of the disease is obvious. The main task of modern pulmonology is the search for prognostic markers of several complex parameters, capable of ensuring the timely prognosis and choice of adequate therapy. The presence of comorbid diseases and high frequency of exacerbations in COPD patients should be treated as such markers.

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Section: клинико-анамнестические критерии прогрессирующего течения хоблunclassified

Difficulty of Copd Predicting as a Challenge to Modern Clinical Pulmonology

et al. 2016

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“…These phenotypes are still being refined but generally are classified as: Asthma-COPD Overlap Syndrome (ACOS), frequent exacerbators (more than twice a year) who are more likely to have eosinophilic inflammation, and less frequent exacerbators who have more neutrophilic inflammation. 3,8,9 An emphysemic phenotype is also suggested. 9 A New Zealand cross-sectional study found five different phenotypes -moderate-severe childhood onset atopic asthma; ACOS; obesecomorbid; mild childhood onset atopic asthma and mild intermittent.…”

Section: Key Pointsmentioning

confidence: 99%

“…3,8,9 An emphysemic phenotype is also suggested. 9 A New Zealand cross-sectional study found five different phenotypes -moderate-severe childhood onset atopic asthma; ACOS; obesecomorbid; mild childhood onset atopic asthma and mild intermittent. 10 The clinical categorization of these phenotypes is difficult, particularly for ACOS as diagnosis of asthma in childhood may have been a wheeze rather than asthma per se.…”

Section: Key Pointsmentioning

confidence: 99%

Nuggets of Knowledge: COPD – targeting the use of inhaled corticosteroids

Bryant¹

2016

J Prim Health Care

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“…We are beginning to understand that the heterogeneity of COPD begets different natural histories. Of the many classifications of COPD phenotypes, three have been associated with natural history and response to therapy [8]. These are: the frequent exacerbator; the overlapping COPD/asthma patient; and the emphysema-hyperinflation patient.…”

Section: @Erspublicationsmentioning

confidence: 99%

The natural history of COPD: confirming and going beyond Fletcher and Peto

Miller

Raskin

2014

Eur Respir J

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@ERSpublicationsFindings of Fletcher and Peto confirmed, and importance of early COPD stages in FEV1 decline and treatment emphasised http://ow.ly/xnKns ''The natural history of chronic airflow obstruction'', initially published in the BMJ in 1977 by FLETCHER and PETO [1], and preceded by a fuller monograph [2], has long been a part of the landscape of pulmonary medicine. Their insights have helped form our collective thinking as we interpret pulmonary function in relation to ageing and lung disease.In this issue of the European Respiratory Journal (ERJ), contribute to our knowledge of chronic obstructive pulmonary disease (COPD) clinical status and progression in a study of 103 younger and 463 older patients followed for o2 years. All patients attended specialised pulmonary clinics, had smoked for o20 pack-years and were (presumably) symptomatic from their physiciandiagnosed COPD. The majority (59%) of the younger patients were ''active smokers'' compared with only 20% of the older group. The rapid decliners in this study may be considered similar to the susceptible smokers who demonstrated rapid decline in the study by FLETCHER and PETO [1]. The Fletcher-Peto cohort was a random sample of 792 employed middle-aged Caucasian males who were followed for 8 years. Presciently, 37 years ago, this cohort demonstrated that not all smokers are susceptible to losing lung function and that in the susceptible smokers, continued smoking accelerates loss. As in the Fletcher-Peto cohort, which followed only males, and in the BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) cohort study by CASANOVA et al. [4], in which 92% were male, the study by is heavily weighted to males, with 85% of the younger and 92% of the older patients being male. Data on females were provided by the Framingham Offspring Cohort [5] (4391 community residents followed for 23 years, of whom 51% were females) and by the Lung Health Study [6] (5885 COPD patients followed for o14.5 years, of whom 37% were females). The absence of data on females renders the study by less applicable to population analysis for rates of change in forced expiratory volume in 1 s (FEV1). The Framingham cohort showed a lower decline in females who continued to smoke compared with males (23.9 versus 38.2 mL?yr -1 ), and fewer female smokers who developed airflow obstruction (24.2%) than male smokers (33.0%) [5].Many of the core findings of FLETCHER and PETO [1] have been confirmed in studies of smokers and/or COPD patients published since their report. A range of susceptible smokers develop airflow obstruction. This range is fairly consistent considering the differences in subject selection: 42-46% of the clinical COPD patients in the study by , excluding any with bronchial responsiveness; 33% of males (24% of females) in the Framingham cohort [5]; 25% of the Nishimura group, most of whom had mild-to-moderate COPD [7]; and 18% in the BODE cohort [4] of ''well-characterised'' COPD patients (mean forced expiratory volume in 1 s (FEV1) 46% predicted). In...

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Clinical Phenotypes of COPD: Identification, Definition and Implications for Guidelines

Cited by 136 publications

References 151 publications

Difficulty of Copd Predicting as a Challenge to Modern Clinical Pulmonology

Difficulty of Copd Predicting as a Challenge to Modern Clinical Pulmonology

Nuggets of Knowledge: COPD – targeting the use of inhaled corticosteroids

The natural history of COPD: confirming and going beyond Fletcher and Peto

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