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Diagnostic and treatment options for patients with COPD as part of real clinical practice. Approaches to the treatment of patients with various phenotypes according to GOLD (2019): materials of the Council of Experts of the Siberian Federal District, Chita and Buryatia, dated 03.15.19

https://doi.org/10.18093/0869-0189-2020-30-2-245-251

Abstract

Chronic obstructive pulmonary disease (COPD) is a global problem in modern medicine. In recent years, the medical community’s understanding of COPD has changed significantly, which is primarily due to the emergence of a new classification and the identification of various phenotypes of the disease. These changes could not affect the tactics of COPD treatment. The article discusses not only the debatable issues of treating COPD; it provides an overview of changes in international (Global Initiative for Chronic Obstructive Lung Disease, 2018) and national (2019) recommendations, but also the significance and benefits of triple therapy in terms of evidence-based medicine as well as the benefits of extra-fine drugs in the treatment of bronchial obstructive syndrome.

About the Authors

I. V. Demko
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation

Doctor of Medicine, Professor, Head of Department of Internal Medicine No.2 and Postgraduate Physician Training Course, ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022;

Head of Pulmonology and Allergology Center, ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022



L. M. Kudelya
State Novosibirsk Regional Clinical Hospital
Russian Federation

Doctor of Medicine, professor, L.D.Sidorova Department of Internal Medicine, Head of the Regional Pulmonary Center, 

ul. Nemirovicha-Danchenko 130, Novosibirsk, 630087



E. A. Sobko
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation

Doctor of Medicine, professor, Associate Professor, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022;

Head of the Department of Allergology, ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022



I. A. Solov'eva
V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University, Healthcare Ministry of Russia; Krasnoyarsk State Territorial Clinical Hospital
Russian Federation

Candidate of Medicine, Assistant Lecturer, Department of Internal Medicine No.2 and Postgraduate Physician Training Course, ul. Partizana Zheleznyaka 1, Krasnoyarsk, 660022;

ul. Partizana Zheleznyaka 3A, Krasnoyarsk, 660022



I. N. Trofimenko
Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuing Professional Education" of the Ministry of Healthcare of the Russian Federation
Russian Federation

Doctor of Medicine, Associate Professor, Department of Propaedeutics of Internal Medicine, 

mkr Yubilejnyy 100, Irkutsk, 664079



A. V. Tetenevа
Siberian State Medical University, Healthcare Ministry of Russia
Russian Federation

Doctor of Medicine, Associate Professor, Department of Propaedeutics of Internal Diseases,

Moskovskiy tract 2, Tomsk, 634050



A. A. Grebenyuk
Barnaul Regional City Hospital No.5
Russian Federation

Chief of the Respiratory Division,

Zmeinogorskiy trakt 75, Barnaul, 656045



N. G. Ganyukova
S.V.Belyaev State Regional Clinical Hospital of the Kemerovo Region
Russian Federation

Candidate of Medicine, Regional Chief Pulmonologist, Pulmonology Department Physician,

pr. Oktyabr'skiy 22, Kemerovo, 650061



N. S. Gyrgeshkinova
N.A.Semashko State Republican Clinical Hospital, Ministry of Health of the Buryatiya Republic
Russian Federation

Chief of the Respiratory Division, 

ul. Pavlova 12, Ulan-Ude, 670031, Buryatiya Republic



S. A. Luk'yanov
Chita State Medical Academy, Healthcare Ministry of Russia
Russian Federation

Candidate of Medicine, Associate Professor, Department of Propaedeutics of Internal Medicine,

ul. Gor'kogo 39A, Chita, 672090



Ch. Ch. Mandarzhap
Tyva Republic State Republican Hospital No.1
Russian Federation

Pulmonologist, 

ul. Oyuna Kursedi 163, Tyva Republic, Kyzyl, 667003



O. A. Meshcheryakova
Novokuznetsk City Clinical Hospital No.1
Russian Federation

Chief of the Respiratory Division, Рulmonologist, 

Kemerovo Region, pr. Bardina 28, Kemerovo Region, Novokuznetsk, 654057



References

1. Müllerová H., Shukla A., Hawkins A., Quint J. Risk factors for acute exacerbations of COPD in a primary care population: a retrospective observational cohort study. BMJ Open. 2014; 4 (12): e006171. DOI: 10.1136/bmjopen-2014-006171.

2. Johannesdottir S.A., Christiansen C.F., Johansen M.B. et al. Hospitalization with acute exacerbation of chronic obstructive pulmonary disease and associated health resource utilization: A population-based Danish cohort study. J. Med. Econ. 2013; 16 (7): 897–906. DOI: 10.3111/13696998.2013.800525.

3. Chuchalin A.G., Avdeev S.N., Aisanov Z.R. et al. Russian Respipatory Society. Federal Guidelines on Diagnosis and Treatment of Chronic Obstructive Lung Disease. Pul'mo - nologiya. 2014; (3): 15–54 54. DOI: 10.18093/0869-0189-2014-0-3-15-54 (in Russian).

4. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. 2019 Report. Available at: https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf [Accessed: November 11, 2018].

5. King P.T. Inflammation in chronic obstructive pulmonary disease and its role in cardiovascular disease and lung cancer. Clin. Transl. Med. 2015; 4: 26. DOI: 10.1186/s40169-015-0068-z.

6. Pavord I.D., Lettis S., Locantore N. et al. Blood eosinophils and inhaled corticosteroid/long-acting β-2 agonist efficacy in COPD. Thorax. 2016; 71 (2): 118–125. DOI: 10.1136/thoraxjnl-2015-207021.

7. Suissa S., Dell'Aniello S., Ernst P. Long-term natural history of chronic obstructive pulmonary disease: severe exacerbations and mortality. Thorax. 2012; 67 (11): 957–963. DOI: 10.1136/thoraxjnl-2011-201518.

8. Miravitlles M., Soler-Cataluña J.J., Calle M., Soriano J.B. Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice. Eur. Respir. J. 2013; 41 (6): 1252–1256. DOI: 10.1183/09031936.00118912.

9. Singh D., Kolsum U., Brightling C.E. et al. Eosinophilic inflammation in COPD: prevalence and clinical characteristics. Eur. Respir. J. 2014; 44 (6): 1697–1700.

10. Kolsum U., Damera G., Pham T.H. et al. Pulmonary inflammation in patients with chronic obstructive pulmonary disease with higher blood eosinophil counts. J. Allergy Clin. Immunol. 2017; 140 (4): 1181–1184e7. DOI: 10.1183/09031936.00162414.

11. Pavord I.D., Chanez P., Criner G.J. et al. Mepolizumab for eosinophilic chronic obstructive pulmonary disease. N. Engl. J. Med. 2017; 377: 1613–1629. DOI: 10.1056/NEJMoa1708208.

12. Ortega H.G., Yancey S.W., Mayer B. et al. Severe eosino - philic asthma treated with mepolizumab stratified by baseline eosinophil thresholds: a secondary analysis of the DREAM and MENSA studies. Lancet Respir. Med. 2016; 4 (7): 549–556. DOI: 10.1016/S2213-2600(16)30031-5.

13. Alfageme I., Reyes N., Merino M. et al. The effect of airflow limitation on the cause of death in patients with COPD. Chron. Respir. Dis. 2010; 7 (3): 135–145. DOI: 10.1177/1479972310368692.

14. Hurst J.R., Vestbo J., Anzueto A. et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N. Engl. J. Med. 2010; 363: 1128–1138.

15. Soler-Cataluña J.J., Rodriguez-Roisin R. Frequent chronic obstructive pulmonary disease exacerbators: How much real, how much fictitious? COPD. 2010; 7 (4): 276–284. DOI: 10.3109/15412555.2010.496817.

16. Cosío B.G., Dacal D., de Llano L.P. Asthma–COPD overlap: identification and optimal treatment. Ther. Adv. Respir. Dis. 2018; 12: 1753466618805662. DOI: 10.1177/1753466618805662.

17. Nevzorova V.A., Avdeev S.N., Kondrashova N.M. et al. [Argumentative issues of chronic obstructive pulmonary disease (materials of panel of experts, Far Eastern Federal District from 06/13/2018, Vladivostok)]. Tikhookeanskiy meditsinskiy zhurnal. 2019; 1 (75): 5–12 (in Russian).

18. Usmani O.S., Biddiscombe M.F., Barnes P.J. Regional lung deposition and bronchodilator response as a function of beta2-agonist particle size. Am. J. Respir. Crit. Care Med. 2005; 172 (12): 1497–1504. DOI: 10.1164/rccm.200410-1414OC.

19. Ovcharenko S.I., Leshchenko I.V. [Chronic Obstructive Pulmonary Disease: Practical handbook]. Edited by A.G.Chuchalin. Moscow: GEOTAR-Media; 2016 (in Russian).

20. Singh D., Brooks J., Hagan G. et al. Superiority of "triple" therapy with salmeterol/fluticasone propionate and tiotropium bromide versus individual components in moderate to severe COPD. Thorax. 2008; 63 (7): 592–598. DOI: 10.1136/thx.2007.087213.

21. Lee S.D., Xie C.M., Yunus F. et al. Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: A randomized, multicentre study in East Asia. Res - pirology. 2016; 21 (1): 119–127. DOI: 10.1111/resp.12646.

22. Usmani O.S., Singh D., Spinola M. et al. The prevalence of small airways disease in adult asthma: a systematic literature review. Respir. Med. 2016; 116: 19–27. DOI: 10.1016/j.rmed.2016.05.006.

23. Avdeev S.N., Aisanov Z.R., Arkhipov V.V. et al. [Agreed recommendations on the rationale for the choice of therapy for bronchial asthma and chronic obstructive pulmonary disease, taking into account the phenotype of the disease and the role of the small respiratory tract]. Atmosfera. Pul'mo - nologiya i allergologiya. 2013; (2): 15–26 (in Russian).

24. Yanai M., Sekizawa K., Ohrui T. et al. Site of airway obstruction in pulmonary disease: direct measurement of intrabronchial pressure. J. Appl. Physiol. (1985). 1992; 72 (3): 1016–1023. DOI: 10.1152/jappl.1992.72.3.1016.

25. Burgel P.R. The role of small airways in obstructive airway diseases. Eur. Respir. Rev. 2011; 20 (119): 023–033. DOI: 10.1183/09059180.00010410.

26. Postma D.S., Brightling C., Baldi S. et al. Exploring the relevance and extent of small airways dysfunction in asthma (ATLANTIS): baseline data from a prospective cohort study. Lancet Respir. Med. 2019; 7 (5): 402–416. DOI: 10.1016/S2213-2600(19)30049-9.

27. Cottini M., Lombardi C., Micheletto C. Small airway dys - function and bronchial asthma control: the state of the art. Asthma Res. Prac. 2015; 1: 13. DOI: 10.1186/s40733-015-0013-3.

28. Wedzicha J.A., Singh D., Vestbo J. et al. Extrafine beclo - methasone/formoterol in severe COPD patients with history of exacerbations. Respir. Med. 2014; 108 (8): 1153–1162. DOI: 10.1016/j.rmed.2014.05.013.

29. Singh D., Corradi M., Spinola M. et al. Extrafine beclo - metasone diproprionate/formoterol fumarate: a review of its effects in chronic obstructive pulmonary disease. NPJ Prim. Care Respir. Med. 2016; 26: 16030. DOI: 10.1038/npjpcrm.2016.30.

30. Brusselle G., Pavord I.D., Landis S. et al. Blood eosinophil levels as a biomarker in COPD. Respir. Med. 2018; 138: 21–31. DOI: 10.1016/j.rmed.2018.03.016.

31. Nair P. Update on clinical inflammometry for the management of airway diseases. Can. Respir. J. 2013; 20: 602936. DOI: 10.1155/2013/602936.

32. Lipworth B.J., Kuo C.R., Jabbal S. Current appraisal of single inhaler triple therapy in COPD. Int. J. Chron. Obstruct. Pulmon. Dis. 2018; 13: 3003–3009. DOI: 10.2147/copd.s177333.

33. Postma D.S., Roche N., Colice G. et al. Comparing the effectiveness of small-particle versus large-particle inhaled corticosteroid in COPD. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9 (1): 1163–1186. DOI: 10.2147/COPD.S68289.

34. Crisafulli E., Pisi R., Aiello M. et al. Prevalence of small-airway dysfunction among COPD patients with different GOLD stages and its role in the impact of disease. Respiration. 2017; 93: 32–41. DOI: 10.1159/000452479.

35. Singh D., Nicolini G., Bindi E. et al. Extrafine Beclometha - sone/Formoterol Compared to Fluticasone/Salmeterol Combination Therapy in COPD. BMC Pulm Med. 2014; 14: 43. DOI: 10.1186/1471-2466-14-43.

36. Sonnappa S., Martin R., Israel E. et al. Risk of pneumonia in obstructive lung disease: A real-life study comparing extra-fine and fine-particle inhaled corticosteroids. PLoS One. 2017; 15; 12 (6): e0178112. DOI: 10.1371/journal.pone.0178112.


Review

For citations:


Demko I.V., Kudelya L.M., Sobko E.A., Solov'eva I.A., Trofimenko I.N., Tetenevа A.V., Grebenyuk A.A., Ganyukova N.G., Gyrgeshkinova N.S., Luk'yanov S.A., Mandarzhap Ch.Ch., Meshcheryakova O.A. Diagnostic and treatment options for patients with COPD as part of real clinical practice. Approaches to the treatment of patients with various phenotypes according to GOLD (2019): materials of the Council of Experts of the Siberian Federal District, Chita and Buryatia, dated 03.15.19. PULMONOLOGIYA. 2020;30(2):245-251. (In Russ.) https://doi.org/10.18093/0869-0189-2020-30-2-245-251

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