RT Journal Article
T1 Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort
A1 Cosio, Borja G.
A1 Calle Rubio, Myrian
A1 Lucas Ramos, Pilar De
A1 Alfageme, Inmaculada
A2 Sanjay Haresh Chotirmall, 
AB Rationale: The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes.Objective: We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes.Methods: We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes.Results: Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%); ACOS, 125 (15.0%); FEE, 38 (4.6%); and FECB, 99 (11.9%); additionally 19 (2.3%) COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p<0.05). The FECB phenotype had the highest CAT score (17.1±8.2, p<0.05 compared to the other phenotypes). Frequent exacerbator groups (FEE and FECB) were receiving more pharmacological treatment at baseline, and also experienced more exacerbations the year after (all p<0.05) with no differences in one-year mortality. Most of NE (93%) and half of exacerbators were stable after one year.Conclusions: There is an uneven distribution of COPD phenotypes in stable COPD patients, with significant differences in demographics, patient-centered outcomes and health care resources use.
PB Public Library of Science
SN 1932-6203
YR 2016
FD 2016-09-29
LK https://hdl.handle.net/20.500.14352/96878
UL https://hdl.handle.net/20.500.14352/96878
LA eng
NO Cosio BG, Soriano JB, López-Campos JL, Calle M, Soler JJ, de-Torres JP, Soler JJ, de-Torres JP, Marín JM, Martínez C, de Lucas P, Mir I, Peces-Barba G, Feu-Collado N, Solanes I, Alfageme I; CHAIN study. Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort. PLoS One. 2016;11:e0160770.
DS Docta Complutense
RD 27 abr 2025