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Incident Chronic Obstructive pulmoNary dIsease Cohort Study (ICONIC)

Not Applicable
Recruiting
Conditions
Chronic Obstructive Pulmonary Disease
Smokers
Interventions
Other: Exhaustive exploration
Registration Number
NCT04252781
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

Chronic Obstructive Pulmonary Disease (COPD), , secondary to smoking, is a major public health issue with very high direct and indirect costs. The impact on the health system of undiagnosed patients, up to 70% of patients, is increasingly documented. However, systematic spirometry screening remains controversial among smokers in the absence of data to link the detection of new patients with improved management and clinical events and health goals. More generally, there is little data on the evolution of patients in real life once they have entered the care system.

The premise is that with systematic screening in general medicine, it is possible to identify the evolution of newly diagnosed COPD patients, to distinguish the different possible evolutions according to the initial phenotype and the management.

Detailed Description

A description of the population from which the groups or cohorts will be selected Smokers who have a screening spirometry for COPD, either in general medicine, at a pulmonologist or in the CHIC or Henri Mondor hospital respiratory function tests department.

After screening, an equal number of men and women COPD will be included (150 men and 150 women). 1500 smokers will be included to reach 300 smokers with COPD.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
300
Inclusion Criteria

Inclusion criteria of smokers with spirometry (pre-inclusion)

  • Age> 35 years
  • Smoking > 20 PA
  • Active smoking (cessation < 1 month)
  • Signature of consent to participate in Phase I of the study

Inclusion criteria for patients with incidental COPD

  • FEV1 / FVC <70% of the theoretical value and / or <LLN (Lower limit of normal)
  • Signature of consent to participate in Phase II of the study
Exclusion Criteria
  • Known COPD
  • Cancer being treated
  • No affiliation to the social security or other social protection scheme
  • Pregnant or lactating woman
  • Patient deprived of liberty or under legal protection (under tutorship or curatorship

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Exhaustive explorationExhaustive explorationExhaustive exploration of newly diagnosed COPD patients (pulmonary pathology and associated comorbidities)
Primary Outcome Measures
NameTimeMethod
1-year adverse evolutionat 12 Months

1-year adverse evolution defined by a composite criterion associating:

- Occurrence of an additional exacerbation defined by any event requiring the use of the care system (visit to the doctor, emergencies, or hospitalization, for respiratory aggravation) with prescription of antibiotics or systemic steroids

AND/OR

- Increased dyspnea by 1 point on the MMRC dyspnea score

AND/OR

- CAT\> 10 or 2 points increase on CAT symptom scores

Secondary Outcome Measures
NameTimeMethod
Adverse evolutionat 3 Months and 6 Months

- Occurrence of an additional exacerbation defined by any event requiring the use of the care system (visit to the doctor, emergencies, or hospitalization, for respiratory aggravation) with prescription of antibiotics or systemic steroids

AND/OR

- Increased dyspnea by 1 point on the MMRC dyspnea score

AND/OR

- CAT\> 10 or 2 points increase on CAT symptom scores

DLCO / Respiratory function parametersat 12 Months

Respiratory function parameters with DLCO

Residual volume / Respiratory function parametersat 12 Months

Respiratory function parameters with residual volume

Arterial stiffnessat 12 Months

Arterial stiffness measured by the pulse wave velocity (Complior)

Numbers of deathsat 12 Months

Numbers of deaths

Exacerbationat 3 Months, 6 Months and 12 Months

Occurrence of an additional exacerbation defined by any event requiring the use of the care system (visit to the doctor, emergencies, or hospitalization, for respiratory aggravation) with prescription of antibiotics or systemic steroids

FEV 1 / Respiratory function parametersat 12 Months

Respiratory function parameters with FEV 1

Total lung capacity / Respiratory function parametersat 12 Months

Respiratory function parameters with total lung capacity

Skeletal muscle indexat 12 Months

Skeletal muscle index evaluated by IDEXA

Number of stepsat 3 Months, 6 Months and 12 Months

Number of steps in the month preceding the visit evaluated by a pedometer

Forced Expiratory Volume in one second (FEV1)at 3 Months, 6 Months and 12 Months

Forced Expiratory Volume in one second (FEV1)

Hospital Anxiety and Depression scaleat 12 Months

Measurement of anxiety symptoms or depression via the Hospital Anxiety and Depression scale.

Diastolic dysfunction / Echocardiographyat 12 Months

diastolic dysfunction measured by echocardiography

PAPS / Echocardiographyat 12 Months

PAPS measured by echocardiography

Muscle functionat 12 Months

Muscle strength by grip and pinch

LVEF / Echocardiographyat 12 Months

LVEF measured by echocardiography

Trial Locations

Locations (1)

Hopital Henri MONDOR

🇫🇷

Créteil, Ile-De-France, France

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