Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort

The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator pheno...

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Bibliographic Details
Published in:PloS one 2016-09, Vol.11 (9), p.e0160770-e0160770
Main Authors: Cosio, Borja G, Soriano, Joan B, López-Campos, Jose Luis, Calle, Myriam, Soler, Juan José, de-Torres, Juan Pablo, Marín, Jose Maria, Martínez, Cristina, de Lucas, Pilar, Mir, Isabel, Peces-Barba, Germán, Feu-Collado, Nuria, Solanes, Ingrid, Alfageme, Inmaculada
Format: Article
Language:English
Subjects:
Access control
Access to information
Asthma
Bronchitis
Care and treatment
Chronic obstructive pulmonary disease
Demographics
Demography
Drug therapy
Dyspnea
Emphysema
Genetic aspects
Genotype & phenotype
Health care
Hospitals
Medicine
Medicine and Health Sciences
Mortality
Patients
People and Places
Pharmacology
Phenotypes
Questionnaires
Respiratory system agents
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Summary:The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes. We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes. We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes. Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%); ACOS, 125 (15.0%); FEE, 38 (4.6%); and FECB, 99 (11.9%); additionally 19 (2.3%) COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0160770