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Phenotypic characteristics of COPD patients with a smoking history in POPE-study in the Russian Federation

https://doi.org/10.18093/0869-0189-2020-30-1-42-52

Abstract

Chronic obstructive pulmonary disease is a significant problem for Russian healthcare. The identification of different clinical phenotypes of the disease may allow individualizing approaches to the treatment of patients with this pathology, while there is insufficient data on the phenotypic characteristics of patients with COPD in Eastern and Central Europe. Methods. The article presents data from 356 outpatient patients with COPD with a smoking history of more than 10 pack/years, who were included in the study randomly without prior selection or invitation. 57.6% of persons were patients without frequent exacerbations. Patients with frequent exacerbations were 33.7% (without the presence of chronic bronchitis – 9.3% and with the presence of chronic bronchitis – 24.4%). An overlap of bronchial asthma and COPD was revealed in 8.7% of the included patients. According to the GOLD (2011), 7% of patients belong to group A, 26.4% to group B, 4.2% to group C, and 63.4% to group D. Results. This paper presents the results of the Russian part of the international POPE-study (Phenotypes of COPD in Central and Eastern Europe), which contains data on COPD clinical phenotypes in Russian patients with a verified diagnosis of COPD. A detailed description of spirometric data, comorbid pathology, and prescribed medications depending on clinical phenotypes is given. A high level of administration of inhaled glucocorticosteroids was revealed, which even patients without frequent exacerbations received in 54% of cases. Conclusion. The obtained data will help to develop optimal approaches to eliminate discrepancies between clinical recommendations for managing patients with COPD and actual clinical practice in Russia.

About the Authors

K. A. Zykov
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; A.I.Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia
Russian Federation

Kirill A. Zykov, Doctor of Medicine, Professor, Deputy Director for Academic Affairs and Innovation, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Head of Laboratory of Pulmonology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia

Orekhovyy bul'var 28, Moscow, 115682
ul. Delegatskaya 20, build. 1, Moscow, 127473
tel.: (495) 413-61-50



S. I. Ovcharenko
I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University)
Russian Federation

Svetlana I. Ovcharenko, Doctor of Medicine, Professor, Department No.1 of General Internal Medicine, Medical Faculty

ul. Trubetskaya 8, build. 2, Moscow, 119991
tel.: (499) 248-45-23



S. N. Avdeev
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University)
Russian Federation

Sergey N. Avdeev, Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Department of Pulmonology, I.M.Sechenov First Moscow State Medical University, Healthcare Ministry of Russia (Sechenov University); Deputy Director for Science, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; Chief Pulmonologist, Healthcare Ministry of Russia

Orekhovyy bul'var 28, Moscow, 115682
ul. Trubetskaya 8, build. 2, Moscow, 119991
tel.: (495) 708-35-76



A. V. Zhestkov
Samara State Medical University, Healthcare Ministry of Russia
Russian Federation

ul. Chapayevskaya 89, Samara, 443099



M. M. Il'kovich
Academician I.P.Pavlov Federal First Saint-Petersburg State Medical University, Healthcare Ministry of Russia
Russian Federation

Mikhail M. Il'kovich, Doctor of Medicine, Professor, Head of pulmonology Department of Postgraduate School, Director of Interstitial and Orphan Lung Diseases

ul. L'va Tolstogo 6–8, Saint-Petersburg, 197089
tel.: (812) 338-78-32



V. A. Nevzorova
Pacific State Medical University, Healthcare Ministry of Russia
Russian Federation

Vera A. Nevzorova, Doctor of Medicine, Professor, Director of Institute of Therapy and Instrumental Diagnostics

pr. Ostryakova 2, Vladivostok, 690002
tel.: (4232) 45-63-67



U. R. Farkhutdinov
Bashkir State Medical University
Russian Federation

Usman R. Farkhutdinov, Doctor of Medicine, Professor at Department of Propaedeutics of Internal Diseases

ul. Lenina 3, Ufa, 450000, Bashkortostan Republic
tel.: (4232) 45-63-67



R. F. Khamitov
Kazan’ State Medical University, Healthcare Ministry of Russia
Russian Federation

Rustem F. Khamitov, Doctor of Medicine, Professor, Head of Department of Internal Medicine No.2

ul. Butlerova 49, Kazan', 420012, Tatarstan Republic
tel.: (843) 224-51-31



A. V. Rvacheva
A.I.Evdokimov Moscow State University of Medicine and Dentistry, Healthcare Ministry of Russia
Russian Federation

Anna V. Rvacheva, Candidate of Medicine, Leading Researcher, Laboratory of Pulmonology

ul. Delegatskaya 20, build. 1, Moscow, 127473
tel.: (903) 661-16-37



A. G. Chuchalin
N.I.Pirogov Federal Russian National Research Medical University, Healthcare Ministry of Russia
Russian Federation

Aleksandr G. Chuchalin, Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of Department of Hospital Internal Medicine. Pediatric Faculty; Chairman of the Executive Board of Russian Respiratory Society

ul. Ostrovityanova 1, Moscow, 117997
tel.: (499) 780-08-50



References

1. Global Initiative for Chronic Obstructive Lung Disease. 2020 Global Strategy for the Diagnosis, Management and Prevention of COPD. Available at: https://goldcopd.org/gold-reports/

2. Jones P.W. Health status and the spiral of decline. J. COPD. 2009. 6 (1): 59–63. DOI: 10.1080/15412550802587943.

3. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease Global Initiative for Chronic Obstructive Lung Disease. 2011 Report. Available at: http://www.goldcopd.org/

4. Han M.K., Agusti A., Calverley P.M. et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. Am. J. Respir. Crit. Care Med. 2010; 182 (5): 598–604. DOI: 10.1164/rccm.200912-1843CC.

5. Koblizek V., Chlumsky J., Zindr V. et al. Chronic obstructive pulmonary disease: official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc Czech Repub. 2013; 157 (2): 189–201. DOI: 10.5507/bp.2013.039.

6. Chuchalin A.G., Avdeev S.N., Aisanov Z.R. et al. Russian Respiratory Society. Federal guidelines on diagnosis and treatment of chronic obstructive pulmonary disease. Pul'monologiya. 2014; (3): 15–54. DOI: 10.18093/0869-0189-2014-0-3-15-54 (in Russian).

7. Zbozinkova Z., Barczyk A., Tkacova R. et al. POPE study: rationale and methodology of a study to phenotype patients with COPD in Central and Eastern Europe. Int. J. Chron. Obstruct. Pulmon. Dis. 2016; 11 (1): 611–622. DOI: 10.2147/COPD.S88846.

8. Miravitlles M., Soler-Cataluña J.J., Calle M. et al. Spanish guideline for COPD (GesEPOC). Update 2014. Arch. Bronconeumol. 2014; 50 (Suppl. 1): 1–16. DOI: 10.1016/S0300-2896(14)70070-5.

9. Charlson M.E., Pompei P., Ales K.L., MacKenzie C.R. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chronic. Dis. 1987; 40 (5): 373–383. DOI: 10.1016/0021-9681(87)90171-8.

10. Miller M.R., Hankinson J., Brusasco V. et al. Standardisation of spirometry. Eur. Respir. J. 2005; 26 (2): 319–338. DOI: 10.1183/09031936.05.00034805.

11. Pellegrino R., Viegi G., Brusasco V. et al. Interpretative strategies for lung function tests. Eur. Respir. J. 2005; 26 (5): 948–968. DOI: 10.1183/09031936.05.00035205.

12. Roca J., Burgos F., Sunyer J. et al. References values for forced spirometry. Group of the European Community Respiratory Health Survey. Eur. Respir. J. 1998; 11 (6): 1354–1362. DOI: 10.1183/09031936.98.11061354.

13. Diab N., Gershon A.S., Sin D.D. et al. Underdiagnosis and overdiagnosis of chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2018; 198 (9): 1130–1139. DOI: 10.1164/rccm.201804-0621CI.

14. Miravitlles M., Vogelmeier C., Roche N. et al. A review of national guidelines for management of COPD in Europe. Eur. Respir. J. 2016; 47 (2): 625–637. DOI: 10.1183/13993003.01170-2015.

15. Burrows B., Hopkins J., Fletcher C.M. et al. The emphysematous and bronchial types of chronic airways obstruction: A clinicopathological study of patients in London and Chicago. Lancet. 1966; 287 (7442): 830–835. DOI: 10.1016/s0140-6736(66)90181-4.

16. Cosio B.G., Soriano J.B., López-Campos J.L. et al. Distribution and outcomes of a phenotype-based approach to guide COPD management: results from the CHAIN cohort. PLoS One. 2016; (11): e0160770. DOI: 10.1371/journal.pone.0160770.

17. Koblizek V., Milenkovic B., Barczyk A. et al. Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE study. Eur. Respir. J. 2017; 49 (5): 1601446. DOI: 10.1183/13993003.01446-2016.

18. Pasquale M.K., Sun S.X., Song F. et al. Impact of exacerbations on health care cost and resource utilization in chronic obstructive pulmonary disease patients with chronic bronchitis from a predominantly Medicare population. Int. J. Chron. Obstruct. Pulmon. Dis. 2012; 7: 757–764. DOI: 10.2147/COPD.S36997.

19. Lindberg A., Sawalha S., Hedman L. et al. Subjects with COPD and productive cough have an increased risk for exacerbations and death. Respir. Med. 2015; 109 (1): 88–95. DOI: 10.1016/j.rmed.2014.12.001.

20. Martinez F.J., Calverley P.M., Goehring U.M. et al. Effect of roflumilast on exacerbations in patients with severe chronic obstructive pulmonary disease uncontrolled by combination therapy (REACT): a multicentrer randomized controlled trial. Lancet. 2015; 385 (9971): 857–866. DOI: 10.1016/S0140-6736(14)62410-7.

21. Wedzicha J.A., Singh D., Vestbo J. et al. Extrafine beclomethasone/formoterol in severe COPD patients with history of exacerbations. Respir. Med. 2014; 108 (8): 11531162. DOI: 10.1016/j.rmed.2014.05.013.

22. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2016 Update. Available at: https://ginasthma.org/wp-content/uploads/2016/04/GINA2016-main-report_tracked.pdf [Accessed: May 26, 2016].

23. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of COPD. 2017 Report. Available at: http://goldcopd.org [Accessed: January 8, 2017].

24. Tudoric N., Koblizek V., Miravitlles M. et al. GOLD 2017 on the way to a phenotypic approach? Analysis from the phenotypes of COPD in Central and Eastern Europe (POPE) Cohort. Eur. Respir. J. 2017; 49 (4): 1602518. DOI: 10.1183/13993003.02518-2016.


Review

For citations:


Zykov K.A., Ovcharenko S.I., Avdeev S.N., Zhestkov A.V., Il'kovich M.M., Nevzorova V.A., Farkhutdinov U.R., Khamitov R.F., Rvacheva A.V., Chuchalin A.G. Phenotypic characteristics of COPD patients with a smoking history in POPE-study in the Russian Federation. PULMONOLOGIYA. 2020;30(1):42-52. (In Russ.) https://doi.org/10.18093/0869-0189-2020-30-1-42-52

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ISSN 0869-0189 (Print)
ISSN 2541-9617 (Online)