0000000000039980
AUTHOR
Marc Miravitlles
GOLD 2017 on the way to a phenotypic approach? Analysis from the Phenotypes of COPD in Central and Eastern Europe (POPE) Cohort.
The distribution of patients based on exacerbations solely is the most profound consequence of the 2017 GOLD Report http://ow.ly/4UJa309fLbM
New horizons in early stage COPD--improving knowledge, detection and treatment.
SummaryEarly stage COPD carries a significant healthcare burden that is currently underrecognised, underdiagnosed and undertreated. Furthermore, patients at this stage can rapidly decline to advanced disease, especially if they continue to smoke. The natural history of the disease in early stages remains largely unknown, and emerging evidence indicates that we are able to reduce lung function decline and exacerbations, and improve quality of life, in early stage COPD, mainly through smoking cessation. But new evidence from randomised clinical trials also suggests an impact of pharmacotherapy on clinical outcomes in early disease. Guidelines need to be updated to reflect this greater underst…
LATE-BREAKING ABSTRACT: Phenotypes of COPD in central and Eastern Europe - The POPE study
Introduction: Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries. However, data regarding symptom load and clinical phenotypes of patients with COPD in CEE remain largely unknown. Methods: Participation in the POPE Study (a multicentre, observational cross-sectional survey) was offered to consecutive outpatients with stable COPD in 11 CEE countries if they fulfilled the following criteria: age ≥ 40 years, smoking history ≥ 10 pack-years, post-bronchodilator (BD) FEV 1 /FVC Results: 3504 patients (66 ± 8.7 yrs, 69% male, post-BD FEV 1 53.0 ± 17.5% predicted, Charlson comorbidity index 2.0 ± 1.4, and 1.2 ± 1.6 exacerb…
CAT in COPD phenotypes (POPE study)
Background: The COPD assessment test (CAT) is widely used for basic symptom evaluation in patients with COPD. The impact of COPD phenotypes on symptom scores using the CAT, however, remains largely unknown. Methods: The POPE-Study (NCT02119494) is an international, multicentre, observational cross-sectional survey of consecutive patients with COPD in Central and Eastern Europe (CEE). Respiratory symptoms using the modified Medical Research Council (mMRC) dyspnoea scale, and the CAT were recorded. Inclusion criteria: age ≥ 40 years, smoking history ≥ 10 pack-years, post-bronchodilator (BD) FEV1/FVC Results: 3366 COPD subjects (66 ± 8.8 yrs, post-BD FEV1 52.8 ± 18.5 % predicted, CAT 17.4 ± 7.…
Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE Study.
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% frequen…
Protocol for the EARCO Registry
Rationale and objectives Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that leads to an increased risk of emphysema and liver disease. Despite extensive investigation, there remain unanswered questions concerning the natural history, pathophysiology, genetics and the prognosis of the lung disease in association with AATD. The European Alpha-1 Clinical Research Collaboration (EARCO) is designed to bring together researchers from European countries and to create a standardised database for the follow-up of patients with AATD. Study design and population The EARCO Registry is a non-interventional, multicentre, pan-European, longitudinal observational cohort study enrolling patie…
Liver Fibrosis and Metabolic Alterations in Adults With alpha-1-antitrypsin Deficiency Caused by the Pi*ZZ Mutation
Background & Aims Alpha-1 antitrypsin deficiency (AATD) is among the most common genetic disorders. Severe AATD is caused by a homozygous mutation in the SERPINA1 gene that encodes the Glu342Lys substitution (called the Pi*Z mutation, Pi*ZZ genotype). Pi*ZZ carriers may develop lung and liver diseases. Mutation-associated lung disorders have been well studied, but less is known about the effects in liver. We assessed the liver disease burden and associated features in adults with this form of AATD. Methods We collected data from 554 Pi*ZZ adults (403 in an exploratory cohort, 151 in a confirmatory cohort), in 9 European countries, with AATD who were homozygous for the Pi*Z mutation, and 234…
Alpha-1 antitrypsin deficiency: outstanding questions and future directions
BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is a rare hereditary condition that leads to decreased circulating alpha-1 antitrypsin (AAT) levels, significantly increasing the risk of serious lung and/or liver disease in children and adults, in which some aspects remain unresolved. METHODS: In this review, we summarise and update current knowledge on alpha-1 antitrypsin deficiency in order to identify and discuss areas of controversy and formulate questions that need further research. RESULTS: 1) AATD is a highly underdiagnosed condition. Over 120,000 European individuals are estimated to have severe AATD and more than 90% of them are underdiagnosed. CONCLUSIONS: 2) Several clinical and…
Determinants of CAT (COPD Assessment Test) scores in a population of patients with COPD in central and Eastern Europe: The POPE study
Abstract Background The COPD Assessment Test (CAT) has been proposed to help guide therapy in chronic obstructive pulmonary disease (COPD). It is important to understand the distribution of scores in different COPD populations and their determinants. Methods The POPE study is an international, observational cross-sectional study of COPD subjects in 11 Central and Eastern European countries aimed at characterizing COPD phenotypes. Here we report the analysis of CAT scores with the objective of identifying their determinants, evaluating symptom load and investigating the distribution of scores among the participating countries. Additionally, we investigated the discrepancies between the CAT a…
Pharmacotherapy of COPD in Central and Eastern Europe - The POPE study
Introduction: In Central and Eastern Europe (CEE) the burden of chronic obstructive pulmonary disease (COPD) is high. It remains unknown whether patients are treated in line with GOLD recommendations or according to their phenotypes. Our aim was to analyze the treatment patterns of COPD in CEE. Methods: In the frame of the POPE study (ClinicalTrials.gov - NCT02119494) data including pharmacotherapy were collected in patients with stable COPD across 11 CEE countries. Results: 3366 patients (66±9 yrs, 70% male, FEV 1 53±18%) participated in the study. In all GOLD categories, the most widely used medications were long-acting beta-2 agonists (LABA), followed by long-acting antimuscarinic agents…