GesEPOC 2021: One More Step Towards Personalized Treatment of COPD

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

doi:10.1016/j.arbr.2020.11.004

Cited by 13 publications

(18 citation statements)

References 16 publications

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“…TNM (tumor, node, and metastasis) staging was defined as stated in the 8th edition of the Lung Cancer Stage Classification [ 32 ]. COPD diagnosis was established as a post-bronchodilator forced expiratory volume in one second (FEV 1 )/forced vital capacity (FVC) ≤ 0.7, which is not fully reversible by spirometry according to currently available guidelines for diagnosis and management of COPD [ 33 , 34 ]. Exclusion criteria were: small cell lung cancer (SCLC), chronic cardiovascular disease, restrictive lung disease, metabolic, immune disease, or clot system disorders, signs of severe inflammation and/or bronchial infection (bronchoscopy), current or recent invasive mechanical ventilation, or long-term oxygen therapy.…”

Section: Methodsmentioning

confidence: 99%

Increased PARP Activity and DNA Damage in NSCLC Patients: The Influence of COPD

Tang

Curull

Wang

et al. 2020

Cancers

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(1) Background: Lung cancer (LC) is a major leading cause of death worldwide. Poly (ADP-ribose) polymerase (PARP)-1 and PARP-2 are key players in cancer. We aimed to assess PARP-1 and PARP-2 expression and activity and DNA damage in tumors and non-tumor lungs from patients with/without chronic obstructive pulmonary disease (COPD). (2) Methods: Lung tumor and non-tumor specimens were obtained through video-assisted thoracoscopic surgery (VATS) in LC patients with/without underlying COPD (two groups of patients, n = 15/group). PARP-1 and PARP-2 expression (ELISA), PARP activity (PARP colorimetric assay kit) and DNA damage (immunohistochemistry) levels were identified in all samples. (3) Results: Both PARP-1 and PARP-2 expression levels were significantly lower in lung tumors (irrespective of COPD)compared to non-tumor specimens, while DNA damage and PARP activity levels significantly increased in lung tumors compared to non-tumor specimens only in LC-COPD patients. PARP-2 expression was positively correlated with smoking burden in LC-COPD patients. (4) Conclusions: In lung tumors of COPD patients, an overactivation of PARP enzyme was observed. A decline in PARP-1 and PARP-2 protein expression was seen in lung tumors irrespective of COPD. Other phenotypic features (airway obstruction) beyond cancer may account for the increase in PARP activity seen in the tumors of patients with underlying COPD.

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Section: Methodsmentioning

confidence: 99%

Increased PARP Activity and DNA Damage in NSCLC Patients: The Influence of COPD

Tang

Curull

Wang

et al. 2020

Cancers

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“…However, any change in treatment should be evaluated by the clinician and agreed with the patient, in particular when the disease is not well controlled. 8 , 40 In line with guidelines recommendations, a review of the diagnosis, management of comorbidities, history of symptoms and exacerbations, inhalation technique and adherence to medication should be included. However, it has been identified the potential economic benefits for the Health System to consider when assessing the risks and benefits of therapies, particularly those containing ICS for their COPD patients.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] The goal of pharmacological therapy for the management of COPD is to reduce the symptoms, frequency and severity of exacerbations, as well as to improve the prognosis of the disease. 5,8 Similar to the ABCD groups of the classification according to the GOLD strategy, 5 four phenotypes are defined in the GesEPOC 2017 guidelines: patients with ≤1 exacerbation/year without hospitalization belong to the non-exacerbator phenotype, in patients with ≥2 exacerbations/year or ≥1 hospitalizations a distinction is made between exacerbator with emphysema phenotype and exacerbator with chronic bronchitis phenotype and, finally, a fourth phenotype is defined, the asthma and COPD overlapping (ACO) phenotype. 6 Bronchodilator therapy is the main initial and maintenance treatment for stable COPD in patients not at increased risk of exacerbations.…”

Section: Introductionmentioning

confidence: 99%

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Economic Impact of Low Adherence to COPD Management Guidelines in Spain

Miravitlles¹,

Solé²,

Aguilar³

et al. 2021

COPD

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“…Patients with frequent exacerbations are specifically targeted with more aggressive therapy and an action plan in order to help prevent exacerbations [8,9]. Vitamin D deficiency is common and represents a major health problem.…”

Section: Introductionmentioning

confidence: 99%

Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study

Rubio

Álvarez-Sala

Centanaro

et al. 2022

JCM

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Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels <20 ng/mL at the inclusion visit. Of these, 29 (46%) had serum vitamin D levels <12 ng/mL (severe deficiency). Having a history of inhaled corticosteroids (OR 3.210, p < 0.016), being treated with a cycle of systemic corticosteroids (OR 2.149, p < 0.002), and having a lower physical activity level (OR 3.840, p < 0.004) showed a statistically significant positive association with vitamin D deficiency. Conclusion: The testing of vitamin D levels in patients with high-risk COPD treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, a severe deficiency is detected in one in four patients. Efforts to optimize case detection in COPD are needed.

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GesEPOC 2021: One More Step Towards Personalized Treatment of COPD

Cited by 13 publications

References 16 publications

Increased PARP Activity and DNA Damage in NSCLC Patients: The Influence of COPD

Increased PARP Activity and DNA Damage in NSCLC Patients: The Influence of COPD

Economic Impact of Low Adherence to COPD Management Guidelines in Spain

Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study

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