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A1709 - Phenotypes in Patients with Severe and Very Severe COPD in the Russian Federation: Observational Multicenter Non-Interventional Study CLOUD
Author Block: V. Petrakovskaia1, A. Belevskiy2, S. Avdeev3, K. Blong1; 1Medical department, AstraZeneca Pharmaceuticals Russia, Moscow, Russian Federation, 2Pirogov Russian National Research Medical University, Moscow, the Russian Federation, Moscow 105077, Russian Federation, 3Pulmonary Research Institute, Moscow, Russian Federation.
Frequent exacerbations in chronic obstructive pulmonary disease (COPD) lead to a decline of lung function and quality of life, increased risk of mortality and need for therapy modification. The phenotypes of severe and very severe COPD (GOLD 2014 III-IV) patients have not been comprehensively studied in the Russian Federation. The objectives of the study are to identify the most prevalent COPD phenotypes in the Russian Federation and determine the detailed profile including phenotypes combinations of the frequent exacerbator phenotype using the Czech Republic COPD guidelines 2014 in severe and very severe COPD patients among those hospitalized for COPD exacerbation. The frequent exacerbator phenotype was chosen for the detailed evaluation as the phenotype with the least treatment success in the routine practice in the Russian Federation. The population under investigation comprised 852 GOLD III-IV COPD patients (male - 727 (85.3%) and female - 125 (14.7%)) hospitalized for acute exacerbations of COPD enrolled at 36 study centers from 27 cities from March 31 to December 31, 2015. The enrolled patients were ≥40 years old and with a smoking history of ≥10 pack-years. Patients with ≥2 exacerbations per year treated with antibiotics and/or systemic corticosteroids are referred to as the frequent exacerbator phenotype. As a result of the study the structure of the COPD phenotypes was determined: the chronic bronchitis phenotype - 55.2%, the frequent exacerbator phenotype - 46.1%, the emphysema phenotype - 33.8%, COPD and asthma overlap syndrome - 13.9%, the pulmonary cachexia phenotype - 10.7% and bronchiectatic COPD phenotype - 3.9%. One patient could have more than one COPD phenotype (combination of phenotypes). Of all enrolled frequent exacerbator phenotype patients the most prevalent phenotype combinations were: the chronic bronchitis phenotype + the frequent exacerbator phenotype - 17.9%; the emphysema phenotype + the frequent exacerbator phenotype - 8.5%; the emphysema phenotype + the frequent exacerbator phenotype + the pulmonary cachexia phenotype - 3.2%. The results show that among all the patient with the frequent exacerbator phenotype the majority had various phenotype combinations - 40.3% overall and only 5.8% had the frequent exacerbator phenotype in isolation.