Abstract
Background: COPD is a condition with several clinical variants:non-exacerbation phenotype(NON-AE),frequent exacerbations with chronic bronchitis(AE CB),frequent exacerbations without chronic bronchitis(AE NON-CB),and asthma–COPD overlap syndrome(ACOS).The evolution of COPD phenotypes in time and their impact on lung function and symptoms remains largely unknown.
Methods: The Czech Research Database of COPD(NCT01923051)is a multicentre,observational,and prospective study of consecutive patients with severe COPD.Signs identifying phenotypes, lung function, and respiratory symptoms were assessed annually.
Results: 647 severe COPD subjects were enrolled until Jan 16. 113 of them were eligible for two-year analysis (66.8±9.1yrs,73.8% males,post-BD FEV1 43.0±17.7%).On the whole 62.6% were NON-AE,18.8% were AE CB, 7.1% were AE NON-CB,and 11.5 % were ACOS subjects.We found apparent differences in term of COPD phenotypes stability during follow-up.There were stable (ACOS,and NON-AE) and unstable (AE CB, and AE NON-CB) phenotypes (Fig1). With respect to changes of lung function and symptoms we noted significant differences between above mentioned phenotypes.
Conclusion: Two clinical phenotypes (ACOS and NON-AE) of subjects with severe COPD we can described as stable over time.Significant differences in FEV1 declination and symptoms evolution between different COPD phenotypes in the prospective two-year evaluation were noted.
- Copyright ©the authors 2016