Frequency of comorbidities in chronic obstructive pulmonary disease, and impact on all-cause mortality: A population-based cohort study

Laforest, Laurent; Roche, N.; Devouassoux, Gilles; Belhassen, Manon; Chouaïd, C.; Ginoux, M.; Ganse, Éric Van

doi:10.1016/j.rmed.2016.05.019

Cited by 50 publications

(47 citation statements)

References 39 publications

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“…In this study, the prevalence of off-label use of olodaterol and indacaterol was only somewhat higher in Results of the present study indicate that new users of olodaterol and indacaterol represent an elderly population, with a similar sex distribution and a high prevalence of respiratory and nonrespiratory comorbidities and use of comedications. In general, age and sex distribution of new users of olodaterol were similar to that of new users of indacaterol, and were in line with findings in former studies 19,[21][22][23] . A high degree of data on lifestyle characteristics were missing due to type and availability of information in the health care databases.…”

Section: Resultssupporting

confidence: 89%

No Evidence of Off-label Use of Olodaterol and Indacaterol in Denmark, France, and the Netherlands: A Drug Utilization Study

Rebordosa

Houben

Laugesen

et al. 2020

Sci Rep

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To characterize the use of olodaterol and indacaterol in clinical practice and to quantify the off-label use in asthma. Drug utilization study of new users of olodaterol or indacaterol between 2014 and 2017 in the PHARMO Database Network in the Netherlands, the Danish population registers, and the IMS Real-World Evidence Longitudinal Patient Database panels in France. On-label use was defined as use among adults with a recorded diagnosis of COPD. Off-label use was defined as use among adults with a recorded diagnosis of asthma without a recorded diagnosis of COPD or as use among patients aged ≤18 years. Potential off-label use was defined as no recorded diagnosis of either COPD or asthma. The study included 4,158 new users of olodaterol and 9,966 new users of indacaterol. Prevalence of off-label use ranged from 3.5% for both drugs to 12.4% for olodaterol and 11.9% for indacaterol. Prevalence of on-label use ranged from 47.8% to 77.7% for olodaterol and from 28.7% to 70.1% for indacaterol. The remaining new users of olodaterol and indacaterol were classified as potential off-label users, with prevalence ranging from 17.3% to 48.6% for olodaterol and from 20.5% to 66.6% for indacaterol. This study provides no evidence of a major concern in Europe for olodaterol or indacaterol for off-label use in asthma or for pediatric use. Chronic obstructive pulmonary disease (COPD) affects 174 million people worldwide 1. It is a characterized by persistent airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases including smoking 2. Four inhaled long-acting beta2-agonists (LABAs) (salmeterol, formoterol, indacaterol, and olodaterol) are approved for long-term maintenance treatment in patients with COPD. Salmeterol and formoterol are also approved for use in asthma. Olodaterol was first approved in the countries of the European Union since 2013 and is indicated as a maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD 3. The use of LABAs as monotherapy in asthma without COPD, without a primary anti-inflammatory controller medication, e.g., an inhaled glucocorticosteroid (ICS), has been associated with increased morbidity and mortality 4,5. There were no such concerns if the patient has COPD and concomitant asthma, an overlap of asthma and COPD, or COPD alone. Therefore, the health authorities of the European Union (EU)/European Economic Area Member States requested the conduct of a post-approval drug utilization study to characterize the use of olodaterol in clinical practice and assess the potential off-label use of olodaterol in asthma (see study protocol at EU PAS Register # EUPAS 17386) 6. The main objectives of the study were to describe the baseline characteristics of patients initiating on olodaterol and to quantify off-label use of

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Section: Resultssupporting

confidence: 89%

No Evidence of Off-label Use of Olodaterol and Indacaterol in Denmark, France, and the Netherlands: A Drug Utilization Study

Rebordosa

Houben

Laugesen

et al. 2020

Sci Rep

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“…Cardiovascular diseases are the most frequent followed by diabetes, depression and cancers, anxiety and depression. 7,8 Loss of oxidative type of muscle fibre, atrophy, and increased protein turnover are mechanisms explained for sarcopenia. 9 In a study done by Van Manen comorbidities were present in more than 50% of patients.…”

Section: Discussionmentioning

confidence: 99%

Relation between body mass index, forced expiratory volume in one second and 6 minute walk test in stable COPD patients

2016

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“…Die mittlere jährliche Sterberate der COPD-Patienten betrug in der schon eingangs aufgeführten französischen Kohortenstudie 4,9 % und lag bei Männern mit 5,7 % höher als bei Frauen mit 3,9 %, wobei sich eine Häufigkeit kardiovaskulärer Erkrankungen im Gesamtkollektiv von 68,7 % ergab. Als Konsequenz geben die Autoren an, einen verstärkten Fokus insbesondere auf die kardiovaskulären Komorbiditäten der COPD zu richten [10].…”

Section: Die Bei Derunclassified

“…Patienten mit einer COPD sind durch ein bis zu 3-fach erhöhtes Mortalitätsrisiko gegenüber Nicht-COPD-Patienten und ein hohes Maß an kardiovaskulären Komorbiditäten belastet. Nach einer französischen Kohortenstudie mit 4237 Patienten sind 68,7 % der COPD-Patienten kardiovaskulär erkrankt, ferner weisen 15,2 % einen Diabetes mellitus, 14,2 % eine Depression und 10,6 % eine Malignomerkrankung auf [10]. Diese aus epidemiologischer Sicht hohe kardiovaskuläre Belastung der COPD-Patienten wurde bisher unterschätzt und dürfte pathogenetisch auf den gemeinsamen Risikofaktor Nikotinkonsum, aber auch auf eine subklinische systemische Inflammation und endotheliale Dysfunktion infolge der mit der COPD einhergehenden Exazerbationen und rezidivierenden Infekten zurückzuführen sein.…”

Section: Introductionunclassified

Chronisch obstruktive Lungenerkrankung und koronare Herzkrankheit

Leschke

2019

Klinikarzt

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ZUSAMMENFASSUNGDie Diagnose einer koronaren Herzkrankheit (KHK) bei Patienten mit COPD (chronisch obstruktive Lungenerkrankung) wird häufig verspätet gestellt, da Symptome wie Dyspnoe, thorakale Schmerzen und Palpitationen sowie Herzrhythmusstörungen auf die zugrunde liegende COPD bezogen werden. Nach verschiedenen Studien ist die COPD durch ein bis zu 3-fach erhöhtes Mortalitätsrisiko gegenüber Nicht-COPD-Patienten belastet. Nach einer aktuellen Studie sind 69 % der COPD-Patienten kardiovaskulär erkrankt. So fand sich eine um 2,33 höhere Wahrscheinlichkeit einer stationären Aufnahme wegen einer kardiovaskulären Genese gegenüber Nicht-COPD-Patienten. Wesentlich dürfte dafür eine systemische Inflammation sein, die in Beziehung mit dem Ausmaß der bronchialen Obstruktion und der Air-Flow-Limitation steht und sich laborchemisch durch einen Anstieg des hochsensitiven CRP (C-reaktives Protein), aber auch der Fibrinogenkonzentration insbesondere bei akuten Exazerbationen zeigt. COPD-Patienten haben signifikant erhöhte Troponinkonzentrationen infolge eines Typ-2-Myokardinfarktes aufgrund von Hypoxie und Tachykardie, einer damit sekundären stressbedingten Myokardischämie. Demnach müssen COPD-Patienten sorgfältig bezüglich kardiovaskulärer Risikofaktoren untersucht und kardiale Komorbiditäten diagnostiziert werden.

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Frequency of comorbidities in chronic obstructive pulmonary disease, and impact on all-cause mortality: A population-based cohort study

Abstract: In the French population, major comorbidities are common in COPD, particularly cardiovascular diseases that occur in over two thirds of patients. The impact of comorbidities on mortality was not related to their prevalence, with cancer having the largest impact.

Cited by 50 publications

References 39 publications

No Evidence of Off-label Use of Olodaterol and Indacaterol in Denmark, France, and the Netherlands: A Drug Utilization Study

No Evidence of Off-label Use of Olodaterol and Indacaterol in Denmark, France, and the Netherlands: A Drug Utilization Study

Relation between body mass index, forced expiratory volume in one second and 6 minute walk test in stable COPD patients

Chronisch obstruktive Lungenerkrankung und koronare Herzkrankheit

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