Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study

Abstract

Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region.Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment.3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequent exacerbators with chronic bronchitis, 9.5% frequent exacerbators without chronic bronchitis and 6.9% were classified as asthma–COPD overlap. Differences in the distribution of phenotypes between countries were observed, with the highest heterogeneity observed in the nonexacerbator cohort and the lowest heterogeneity observed in the asthma–COPD cohort. There were statistically significant differences in symptom load, lung function, comorbidities and treatment between these phenotypes.The majority of patients with stable COPD in CEE are nonexacerbators; however, there are distinct differences in surrogates of disease severity and therapy between predefined COPD phenotypes.

GOLD 2017 on the way to a phenotypic approach? Analysis from the Phenotypes of COPD in Central and Eastern Europe (POPE) Cohort

“…The aims of the present study were 1) to analyse the effects of applying the new GOLD 2017 recommendations on the distribution of the A-D groups, and 2) to foresee the possible implications of the new GOLD recommendations on the maintenance therapy for COPD. For this purpose, we used data from the POPE (Phenotypes of COPD in Central and Eastern Europe) study, which is an international, multicentre, observational and cross-sectional study of 3361 COPD subjects in 10 countries in Central and Eastern Europe (CEE) (ClinicalTrials.gov identifier NCT02119494) [3]. The study provided numerous data, including ABCD distribution based on the 2016 GOLD Report and the distribution of predefined clinical COPD phenotypes [3].…”

“…For this purpose, we used data from the POPE (Phenotypes of COPD in Central and Eastern Europe) study, which is an international, multicentre, observational and cross-sectional study of 3361 COPD subjects in 10 countries in Central and Eastern Europe (CEE) (ClinicalTrials.gov identifier NCT02119494) [3]. The study provided numerous data, including ABCD distribution based on the 2016 GOLD Report and the distribution of predefined clinical COPD phenotypes [3]. Its rationale, organisational structure and methodology have been reported in more detail previously [4].…”

“…Its rationale, organisational structure and methodology have been reported in more detail previously [4]. The study protocol, informed consent and patient information were submitted to ethics committees in the respective countries and to regulatory agencies, where required; as a result, all patients were requested to provide their informed consent (except those in Poland, where formal ethics committee approval and written informed consent was not required due to the observational nature of the study) [3].…”

Phenotypes contribute to treatments

“…A series of validation studies has been conducted in different region, and showed some similar results, such as a relatively low number of category C patients, significant heterogeneity in prospective exacerbation rates in category D, no differences in the predictive value of mortality for GOLD 2011 and GOLD 2007, and a better predictive value of exacerbation for GOLD 2011 and GOLD 2007 [18]. KOBLIZEK et al [4] also compared Spanish phenotypes with GOLD categories (2011 version) and showed that the majority of frequent exacerbators were in category D regardless of the coexistence of chronic bronchitis, whereas 39% of non-exacerbators and 56% of those with ACOS were also in category D, indicating marked heterogeneity in this category. In the 2017 update of GOLD, lung function (GOLD stages 1-4) is considered independent of the assessment of GOLD categories A-D, the predictive values of which need to be validated [2].…”

“…In this issue of the European Respiratory Journal, KOBLIZEK et al [4] report an international, multicentre, observational cross-sectional study of COPD subjects in ten Central and Eastern European Countries, the POPE study. 3362 Patients with COPD were recruited and stratified according to the phenotypes recommended by the Spanish and Czech COPD guidelines [5][6][7]: 63% were considered non-exacerbators (NON-AE); 20.4%, with asthma-COPD overlap syndrome (ACOS); 9.5%, frequent exacerbators with chronic bronchitis (AE-CB); and 6.9%, frequent exacerbators without chronic bronchitis (AE NON-CB).…”