Revised (2018) COPD Clinical Practice Guideline of the Korean Academy of Tuberculosis and Respiratory Disease: A Summary

Park, Young Bum; Rhee, Chin Kook; Yoon, Hyoung Kyu; Oh, Yeon‐Mok; Lim, Seong Yong; Lee, Jin Hwa; Yoo, Kwang Ha; Ahn, Joong Hyun

doi:10.4046/trd.2018.0029

Cited by 40 publications

(39 citation statements)

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“…This was lower than adherence to the 2011 GOLD guidelines. This may be due to the fact that guidelines for the treatment of COPD in Korea still use post-bronchodilator FEV 1 as a basis for classifying patients into groups 10. In the Korean COPD guidelines, if FEV 1 is less than 60%, it is recommended that treatment correspond to GOLD group D. Therefore, the two guidelines could be mixed and used in real practice.…”

Section: Discussionmentioning

confidence: 99%

Adherence to the GOLD Guideline in COPD Management of South Korea: Findings from KOCOSS Study 2011–2018

et al. 2019

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The guidelines for chronic obstructive pulmonary disease (COPD) treatment are important for the management of the disease. However, studies regarding the treatment adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been scarce in Korea. Therefore, to examine the adherence to the GOLD guidelines, we examined the patterns of prescribed medication in COPD patients from 2011 to 2018. Patients were classified as having been appropriately and inappropriately treated (overtreatment or undertreatment) for the GOLD group. Appropriate medical therapy was defined as using the first choice or alternative choice drug recommended in the GOLD guidelines. Inappropriate therapy was classified as overtreatment or undertreatment in accordance with the categorization in the GOLD guidelines. According to treatment of 2011 GOLD guidelines, there was inappropriate treatment in 52.3% in group A, 47.3% in group B, 56.3% in group C, and 17.8% in group D. According to treatment of 2017 GOLD guidelines, there was inappropriate treatment in 66.7% in group A, 45.3% in group B, 14.3% in group C, and 24.0% in group D. The common type of inappropriate COPD treatment is overtreatment, with inhaled corticosteroid (ICS) containing regimens. In conclusions, adherence to the GOLD guideline by the pulmonologist in clinical practice is still low in Korea. Therefore, we need better strategies to both optimize the use of the guidelines and adhere to the guidelines as well.

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Section: Discussionmentioning

confidence: 99%

Adherence to the GOLD Guideline in COPD Management of South Korea: Findings from KOCOSS Study 2011–2018

et al. 2019

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“…Patients in GOLD group B are recommended to undergo treatment with a long-acting bronchodilator or consider a combination therapy with two bronchodilators depending on the initial symptoms and clinical progress. 13 Recently, it was reported that inhaled tiotropium could ameliorate the annual FEV 1 decline even in patients with COPD of GOLD stage 1 or 2. 14 However, our study had shown that in the actual field practice, the proportion of patients using inhalers fell short of that of patients treated with oral methylxanthines and LTRA, which take up far more than the recommended medicines in the selection of medication.…”

Section: Discussionmentioning

confidence: 99%

Prescription Status and Clinical Outcomes of Methylxanthines and Leukotriene Receptor Antagonists in Mild-to-Moderate Chronic Obstructive Pulmonary Disease

Lee

Rhee

Kim

et al. 2019

B44. Copd: Treatment and Other Topics

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Background: Methylxanthines and leukotriene receptor antagonists (LTRA) are not a firstline medical treatment for chronic obstructive pulmonary disease (COPD) but are frequently prescribed despite limited evidence. We aimed to elucidate the real prescribing status and clinical impacts of these agents in early COPD patients. Methods: Patients with mild-to-moderate COPD (FEV 1 >50%) were selected from the Korean National Health and Nutrition Examination Survey data between 2007 and 2012. Besides analyzing the prescription status of methylxanthines and LTRA and the contributing factors to the prescription, we evaluated the clinical impacts of these drugs on the exacerbation, hospitalization, and medical costs. Results: Of 2269 patients with mild-to-moderate COPD, 378 patients (16.7%) were under medical treatments, and the users of methylxanthines and/or LTRA were 279 patients (12.3%); however, only 139 patients (6.1%) were inhaler users. The contributing factors for the prescription of methylxanthines were a comorbidity of asthma or allergic disease, poor lung function, low quality of life, prescribing doctor from the specialty of internal medicine, and an institution type of private hospital. The prescription of LTRA was associated with the comorbidity of allergic disease. The methylxanthine and/or LTRA users had more hospital utilization but did not have significant differences in acute exacerbations and medical cost for hospital utilization, compared with the non-users. Conclusion: Methylxanthines and LTRA were used in a significant proportion of patients with mild-to-moderate COPD in real fields without favorable impacts on the exacerbations, hospitalizations, or medical costs. The use of more effective inhaled medications should be encouraged.

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“…Lung function is an important trait of the respiratory system. Lung function measurements of the forced expiratory volume in one second (FEV 1 ) and the ratio of FEV 1 to forced vital capacity (FEV 1 /FVC) are used as criteria for chronic obstructive pulmonary disease (COPD) diagnosis and severity evaluation for pulmonary disease [1,2]. Although environmental factors such as smoking, air pollution and particulate matter influence lung function, the heritability of lung function has been reported to be around 40% [3,4].…”

Section: Introductionmentioning

confidence: 99%

A genome wide association study for lung function in the Korean population using an exome array

Lee

Kim

et al. 2021

Korean J Intern Med

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Background/Aims: Lung function is an objective indicator of diagnosis and prognosis of respiratory diseases. Many common genetic variants have been associated with lung function in multiple ethnic populations. We looked for coding variants associated with forced expiratory volume in 1 second (FEV 1) and FEV 1 /forced vital capacity (FVC) in the Korean general population. Methods: We carried out exome array analysis and lung function measurements of the FEV 1 and FEV 1 /FVC in 7,524 individuals of the Korean population. We evaluated single variants with minor allele frequency greater than 0.5%. We performed look-ups for candidate coding variants associations in the UK Biobank, SpiroMeta, and CHARGE consortia. Results: We identified coding variants in the SMIM29 (C6orf1) (p = 1.2 × 10-5) and HMGA1 locus on chromosome 6p21, the GIT2 (p = 6.5 × 10-5) locus on chromosome 12q24, and the ARHGEF40 (p = 9.9 × 10-5) locus on chromosome 14q11 as having a significant association with lung function (FEV 1). We also confirmed a previously reported association with lung function and chronic obstructive pulmonary disease in the FAM13A (p = 4.54 × 10-6) locus on chromosome 4q22, in TNXB (p = 1.30 × 10-6) and in AGER (p = 1.09 × 10-8) locus on chromosome 6p21. Conclusions: Our exome array analysis identified that several protein coding variants were associated with lung function in the Korean population. Common coding variants in SMIM29 (C6orf1), HMGA1, GIT2, FAM13A, TNXB, AGER and low-frequency variant in ARHGEF40 potentially affect lung function, which warrant further study.

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Revised (2018) COPD Clinical Practice Guideline of the Korean Academy of Tuberculosis and Respiratory Disease: A Summary

Cited by 40 publications

References 100 publications

Adherence to the GOLD Guideline in COPD Management of South Korea: Findings from KOCOSS Study 2011–2018

Adherence to the GOLD Guideline in COPD Management of South Korea: Findings from KOCOSS Study 2011–2018

Prescription Status and Clinical Outcomes of Methylxanthines and Leukotriene Receptor Antagonists in Mild-to-Moderate Chronic Obstructive Pulmonary Disease

A genome wide association study for lung function in the Korean population using an exome array

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