MedPath

Phenotypes of COPD in Central and Eastern Europe

Completed
Conditions
Chronic Obstructive Pulmonary Disease
Registration Number
NCT02119494
Lead Sponsor
Zuzana Zbožínková, M.Sc.
Brief Summary

The purpose of this study is to assess the representation of COPD patients in terms of categories and phenotypes of the disease in selected countries in Central and Eastern Europe (CEE). The results of The POPE study will allow for evaluation of the differences in clinical approaches and treatment practices. The following countries are represented in The POPE study: Czech Republic, Slovakia, Austria, Poland, Hungary, Russia, Croatia, Serbia, Slovenia, Estonia, Latvia and Bulgaria.

Detailed Description

Chronic Obstructive Pulmonary Disease (COPD) is a significant cause of morbidity and mortality in Europe and a major consumer of resources in both primary and secondary healthcare (1,2). Both clinical features of disease severity and quality of COPD patient care may have substantial influence on disease outcomes. Traditionally, COPD has been categorized using the FEV1 (forced expiratory volume at one second ) - based GOLD (The Global Initiative for Chronic Obstructive Lung Disease) classification . Other factors independently associated with survival include age, dyspnoea, health status, hyperinflation, gas exchange abnormalities, exacerbation frequency, exercise capacity, pulmonary hemodynamic, and nutritional status (3). Together these factors explain some of the existent heterogeneity within each GOLD stage in terms of symptoms, exacerbations, quality of life and exercise capacity (4).

Recently, interest has emerged for the identification of clinical COPD phenotypes, as defined by ''a single or combination of disease attributes that describe difference between individuals with COPD as they relate to clinically meaningful outcomes'' (5). Many previous studies have attempted to identify and quantify the prevalence of different phenotypes of COPD using populations of various sources, severities, and particularities. Yet there is no consensus on the number and definition of different phenotypes. However, there must be a compromise between the oversimplification of the term COPD as a definition that encompasses the entire spectrum of patients with incompletely reversible airflow obstruction caused largely by smoking and the complexity of considering each patient individually as an orphan disease.

The most frequently reported phenotypes are emphysema and chronic bronchitis, along with a subset of asthma sufferers. Recently, an extended list of proposed phenotypes have been proposed (6) including: (A) infrequent exacerbators with either chronic bronchitis or emphysema; (B) overlap COPD-asthma; (C) frequent exacerbators with emphysema predominant; and (D) frequent exacerbators with chronic bronchitis predominant. While there is consensus of substantial, but not complete, overlap among these phenotypes, the distribution of these phenotypes may differ widely between different countries and healthcare systems.

Thus, the objectives of this study are to better understand the patient characteristics and treatment patterns of those diagnosed with COPD between different CEE countries. Knowledge of this information may provide insight into the variability of phenotypes between different healthcare systems and may subsequently contribute to a better understanding of the factors associated with patient outcomes and have the potential to improve the care of COPD patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
3504
Inclusion Criteria
  1. Age > 40 years
  2. Clinical diagnosis of COPD with post-bronchodilator FEV1/FVC < 0.7
  3. Smoking burden ≥ 10 pack-years in smokers (group A). Evidence of exposure to at least one other typical inhaled COPD risk factor: environmental tobacco smoke, professional exposures, etc. (group B) Each country will include 300 COPD subjects with positive history of smoking (at least 10 pack-years). Consecutive non-smokers with COPD can be enrolled above this limit. Institute for Biostatistics and Analyses, Masaryk University, Brno, The Czech Republic will analyze both COPD groups (A and B) separately
  4. Stable disease for at least 4 weeks
  5. Outpatient status
  6. Informed Consent
Exclusion Criteria
  1. Exacerbation of COPD and/or instable co-morbid condition
  2. Patient during hospital stay for whatever reason (lung or co-morbidities)
  3. Patient is not able and willing to participate

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The distribution of COPD patients according to GOLD 2011 grades7 months

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 classifies patients according to airflow limitation into four grades: GOLD1, Mild; GOLD 2, Moderate; GOLD 3, Severe; GOLD 4, Very severe

The distribution of COPD patients according to GOLD 2011 categories of risk (A. B, C, D)7 months
Secondary Outcome Measures
NameTimeMethod
The prevalence of various COPD phenotypes7 months

The COPD phenotypes are: bronchitis, emphysema phenotype, frequent exacerbators, pulmonary cachexia, COPD and asthma overlap, and COPD and bronchiectasis overlap

The prevalence of long term oxygen therapy use7 months
The prevalence of surgical treatments in COPD patients7 months
The prevalence various medication prescription7 months
The use of body plethysmography, bronchodilator test, carbon monoxide diffusing capacity testing, bronchial challenge test and FeNO test in ambulatory care7 months

Trial Locations

Locations (79)

Pulmonary Diseases Clinic, Military Medical Academy

🇧🇬

Sofia, Bulgaria

Elizabeth House Care Ltd.

🇭🇺

Gödöllő, Hungary

Oddział Chorób Płuc, Wojewódzkie Centrum Szpitalne Kotliny Jeleniogórskiej,

🇵🇱

Jelenia Góra, Poland

Katedra i Klinika Pneumonologii, Śląski Uniwersytet Medyczny

🇵🇱

Katowice, Poland

Katedra i Klinika Chorób Wewnętrznych, Pneumonologii i Alergologii, Samodzielny Publiczny Centralny Szpital Kliniczny Warszawski Uniwersytet Medyczny,

🇵🇱

Warsaw, Poland

SKA der PV Weyer/Enns

🇦🇹

Mühlein, Austria

Klinika Alergologii i Pneumonologii, Uniwersyteckie Centrum Kliniczne, Szpital Gdańskiego Uniwersytetu Medycznego,

🇵🇱

Gdansk, Poland

Clinic of Pulmonology, MHAT "st. Marina"

🇧🇬

Varna, Bulgaria

Ufa State City Clinical Hospital

🇷🇺

Ufa, Russian Federation

Csongrád County Hospital for Chest Diseases

🇭🇺

Deszk, Hungary

IZO PULM Health Service Ltd.

🇭🇺

Budapest, Hungary

I.M.Sechenov First Moscow State Medical University, University Hospital #1, Outpatient Department

🇷🇺

Moscow, Russian Federation

Clinic for pneumonology and phisiatry, UMHAT "Dr. Georgi Stranski"

🇧🇬

Pleven, Bulgaria

Baja St. Rókus Hospital Patient Lung Care Institute

🇭🇺

Baja, Hungary

Pauls Stradins Clinical University Hospital

🇱🇻

Riga, Latvia

Clinical Hospital

🇭🇷

Osijek, Croatia

University Hospital Centre

🇭🇷

Zagreb, Croatia

University Hospital Dubrava

🇭🇷

Zagreb, Croatia

Department of Respiratory Diseases, Medical University

🇧🇬

Plovdiv, Bulgaria

Moscow State City Clinical Hospital No. 24

🇷🇺

Moscow, Russian Federation

Regional Hospital of Jekabpils

🇱🇻

Jekabpils, Latvia

Oddział Chorób Płuc i Niewydolności Oddychania, Kujawsko - Pomorskie; Centrum Pulmonologii w Bydgoszczy

🇵🇱

Bydgoszcz, Poland

Katedra i Klinika Pulmonologii, Alergologii i Onkologii Pulmonologicznej, Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu

🇵🇱

Poznan, Poland

GBOU VPO Samara State Medical University

🇷🇺

Samara, Russian Federation

St. Elizabeth Hospital Pulmonary Care Institute

🇭🇺

Jászberény, Hungary

Medical Institution of Dr. Laszlo Romics Pulmonary Care

🇭🇺

Érd, Hungary

Moscow State University of Medicine and Dentistry named after A.I.Evdokimov

🇷🇺

Moscow, Russian Federation

Szpital Uniwersytecki, Oddział Kliniczny Kliniki Pulmonologii

🇵🇱

Krakow, Poland

Pulmonology Research Institute

🇷🇺

Moscow, Russian Federation

Bolnišnica Topolšica

🇸🇮

Topolšica, Slovenia

NsP

🇸🇰

Považská Bystrica, Slovakia

State Budget Educational Institution of High Professional Education "Kazan State Medical University"

🇷🇺

Kazan, Russian Federation

Department of Internal Medicine, University Innsbruck

🇦🇹

Innsbruck, Austria

Plicní ambulance Karlovy Vary

🇨🇿

Karlovy Vary, Czech Republic

Szabolcs-Szatmár-Bereg County Hospitals and University Teaching Hospital

🇭🇺

Nyíregyháza, Hungary

rivat practice Ilona Uzbeka

🇱🇻

Valka, Latvia

Clinic of Pulmonology of Scientific and Clinical Center of Interstitial and Orphan Lung Diseases

🇷🇺

St. Petersburg, Russian Federation

Vladivostok Clinical Hospital No.1

🇷🇺

Vladivostok, Russian Federation

FNsP F.D. Roosevelta

🇸🇰

Banská Bystrica, Slovakia

Zdravotné stredisko Fedinova

🇸🇰

Bratislava, Slovakia

Klinika tubekulózy a respiračných chorôb JLF UK a UNM

🇸🇰

Martin, Slovakia

Dionea, s.r.o.

🇸🇰

Nové Zámky, Slovakia

Pľúcna ambulancia

🇸🇰

Poprad, Slovakia

AKH Linz, Department of Pulmonary Medicine

🇦🇹

Linz, Austria

Ambulatory Clinic Dubulti

🇱🇻

Jurmala, Latvia

Kuldīga Hospital

🇱🇻

Kuldīga, Latvia

Health Centre 4, Ltd

🇱🇻

Riga, Latvia

Pulmonary Rehabilitation Centre, Therme Wien

🇦🇹

Vienna, Austria

Plicní ambulance Ostrava Poruba

🇨🇿

Ostrava, Czech Republic

UniClinic

🇱🇻

Riga, Latvia

Clinic for Pulmonary Diseases, Clinical Centre of Serbia

🇷🇸

Belgrade, Serbia

Clinic for Pulmonary Diseases, Clinical Centre Kragujevac

🇷🇸

Kragujevac, Serbia

Ludwig Boltzmann Institute

🇦🇹

Wien, Austria

Pulmonary Outpatient Clinic, University Hospital Hradec Králové

🇨🇿

Hradec Králové, Czech Republic

Plicní ambulance Teplice

🇨🇿

Teplice, Czech Republic

Bauska Hospital

🇱🇻

Bauska, Latvia

Ambulatory Clinic Jelgava

🇱🇻

Jelgava, Latvia

Regional Hospital of Liepaja

🇱🇻

Liepaja, Latvia

Riga East Clinical University Hospital, In-patient Department "Centre of Tuberculosis and Lung Diseases

🇱🇻

Riga, Latvia

Privat practice Dace Harasimjuka

🇱🇻

Valmiera, Latvia

Zdravotné stredisko Rimava

🇸🇰

Rimavská Sobota, Slovakia

Health Centre Balvi

🇱🇻

Balvi, Latvia

Madona Hospital

🇱🇻

Madona, Latvia

LU MPI Institute privat practice

🇱🇻

Riga, Latvia

Klinika pneumológie a ftizeológie LF SZU a UNB,

🇸🇰

Bratislava, Slovakia

Zdravstveni dom Murska Sobota

🇸🇮

Murska Sobota, Slovenia

Privat practice Viktorija Vevere

🇱🇻

Rezekne, Latvia

Municipal Institute for Lung Diseases and Tuberculosis

🇷🇸

Belgrade, Serbia

Riga 1st Hospital

🇱🇻

Riga, Latvia

Health Centre

🇱🇻

Talsi, Latvia

Sia "Bini"

🇱🇻

Ventspils, Latvia

Institute for Pulmonary Diseases and TB, Clinical Centre Vojvodina

🇷🇸

Novi Sad, Serbia

Clinic for Pulmonary Diseases, Clinical Center of Nis

🇷🇸

Nis, Serbia

Alveola, d.o.o.

🇸🇮

Maribor, Slovenia

NsP Sv. Jakuba

🇸🇰

Bardejov, Slovakia

Ambulancia pneumológie a ftizeológie, ZAPA JJ s.r.o.,

🇸🇰

Levice, Slovakia

Újpest Non-Profit Health Care Services Ltd.

🇭🇺

Budapest, Hungary

Federated Institutes of Health Institute of Pulmonary Care

🇭🇺

Pécs, Hungary

Szarvas Respiratory Ltd.

🇭🇺

Szarvas, Hungary

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