Characterisation of exacerbations of chronic bronchitis and COPD in Europe: the GIANT study

• Published in: Therapeutic advances in respiratory disease 2009-12, Vol.3 (6), p.267-277
• Main Authors: Miravitlles, Marc, Anzueto, Antonio, Ewig, Santiago, Legnani, Delfino, Stauch, Kathrin
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Anti-Infective Agents - adverse effects; Anti-Infective Agents - therapeutic use; Antibiotics; Aza Compounds - adverse effects; Aza Compounds - therapeutic use; Bronchitis; Bronchitis, Chronic - drug therapy; Bronchitis, Chronic - physiopathology; Chronic obstructive pulmonary disease; Europe; Female; Fluoroquinolones; Humans; Male; Middle Aged; Practice Guidelines as Topic; Practice Patterns, Physicians; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - physiopathology; Quinolines - adverse effects; Quinolines - therapeutic use; Smoking - adverse effects; Spirometry; Surveys and Questionnaires
• ISSN: 1753-4658; 1753-4666; 1753-4666
• DOI: 10.1177/1753465809352791

Objective: The GIANT study collected information on patients with acute exacerbations of chronic bronchitis (AECB) and chronic obstructive pulmonary disease (COPD) and the effect of treatment with moxifloxacin. Methods: AECB history, concomitant diseases, moxifloxacin treatment, concomitant medication, clinical symptoms and adverse events were recorded. A questionnaire at the end of treatment recorded the impact on patients’ daily lives. Results: Among 9225 patients from eight European countries, marked variation was seen in characteristics including age, smoking history and type of exacerbation. Spirometry use was more common among chest physicians (66.7%) than GPs (15.5%). Patients with Anthonisen type 1 and 2 exacerbations had more frequent exacerbations and these patients experienced a greater impact on daily activities compared with patients with type 3 episodes. Patient symptoms improved with moxifloxacin treatment after a mean (SD) of 3.4 (1.8) days, allowing return to normal daily activities after 5.4 (4.4) days and with full recovery taking 6.5 (3.1) days. Conclusions: Characteristics of patients with AECB and acute exacerbations of COPD differ among European countries. Spirometry is under-used, particularly in primary care and antibiotic treatment does not always follow current guidelines. Results confirm the efficacy of moxifloxacin in the treatment of AECB in real-life conditions.