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Phenotypes of COPD in an Austrian population

National data from the POPE study

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Summary

Background

Chronic obstructive pulmonary disease (COPD) represents a major global health problem; however, there are no data regarding clinical phenotypes of these patients in Austria.

Methods

This was an analysis from the Austrian cohort of the cross-sectional Phenotypes of COPD in Central and Eastern Europe (POPE) study, which was offered to patients with stable COPD in a real-life setting. Patients were recruited at 5 different outpatient facilities in 3 different provinces in Austria. All consecutive patients aged ≥40 years with a diagnosis of COPD confirmed by a post-bronchodilator forced expired volume in 1 s/forced vital capacity (FEV1/FVC) ratio <0.7 during a stable state (≥4 weeks without exacerbation or worsening of any relevant comorbidities) were considered eligible. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analyses of differences in patient characteristics, symptom load, comorbidities, and pharmacological treatment.

Results

Among 283 patients fulfilling the inclusion criteria, 49.5% were considered non-exacerbators, 21.6% were classified as exacerbators with chronic bronchitis, 21.2% exacerbators without chronic bronchitis, and 7.8% were patients with an asthma-COPD overlap. Exacerbators had significantly higher prevalence of symptoms, lower lung function and exercise capacity, and a higher prevalence of comorbidities, such as heart failure and depression, compared with the other patient phenotypes. A large majority of patients with stable COPD in this cohort received inhaled triple therapy, irrespective of exacerbation history.

Conclusions

There were significant differences in COPD outcome measures between predefined phenotypes of COPD in this study. The majority of patients with stable COPD in this Austrian population were not treated according to current COPD guidelines. While non-exacerbators appear to have been overtreated, patients with an asthma-COPD overlap appear to have been undertreated.

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Acknowledgements

The authors thank the staff of all study centers for their cooperation in collecting the study data. The electronic case report form design and statistical analysis for sample size calculations were performed by Z. Zbozinkova, J. Jarkovsky, and M. Uher, from the Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Funding

The sponsor of the POPE study was the Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria. This research institute received an unrestricted research grant from Boehringer Ingelheim, which provided partial support for this study but had no influence on the rationale, methodology or analysis.

Author information

Authors and Affiliations

  1. SKA—Rehabilitationszentrum der PVA, Weyer, Austria

    Gabriele Reiger

  2. Therme Wien Med, Ambulante Pneumologische Rehabilitation, Vienna, Austria

    Ralf Zwick

  3. Department of Pulmonary Medicine, Kepler University Clinic, Linz, Austria

    Bernd Lamprecht

  4. Klinik für Pneumologie, Fachkliniken Wangen, Wangen, Germany

    Christian Kähler

  5. Medical School, Sigmund Freud University, Vienna, Austria

    Otto Chris Burghuber

  6. Department of Respiratory and Critical Care Medicine, Ludwig-Boltzmann-Institute for COPD and Respiratory Epidemiology, Otto-Wagner-Spital, Sanatoriumstraße 2, 1140, Vienna, Austria

    Otto Chris Burghuber &  Arschang Valipour MD, FCCP

Authors
  1. Gabriele Reiger
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  2. Ralf Zwick
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  3. Bernd Lamprecht
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  4. Christian Kähler
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  5. Otto Chris Burghuber
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  6. Arschang Valipour MD, FCCP
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Corresponding author

Correspondence to Arschang Valipour MD, FCCP.

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Conflict of interest

A. Valipour declares that he has received a research grant from Boehringer Ingelheim for the current study. G. Reiger, R. Zwick, B. Lamprecht, C. Kähler, and O.C. Burghuber declare that they have no competing interests.

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Reiger, G., Zwick, R., Lamprecht, B. et al. Phenotypes of COPD in an Austrian population. Wien Klin Wochenschr 130, 382–389 (2018). https://doi.org/10.1007/s00508-018-1347-7

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