Characteristics of COPD patients according to GOLD classification and clinical phenotypes in the Russian Federation: the SUPPORT trial
Received 1 June 2017
Accepted for publication 1 August 2017
Published 3 November 2017 Volume 2017:12 Pages 3255—3262
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Charles Downs
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Vladimir Arkhipov,1 Daria Arkhipova,2 Marc Miravitlles,3 Andrey Lazarev,4 Ekaterina Stukalina5
1Clinical Pharmacology and Therapy Department, Russian Medical Academy of Postgraduate Education, Moscow, Russian Federation; 2Clinical Pharmacology and Propaedeutic Internal Diseases Department, First Moscow State Medical University, Moscow, Russian Federation; 3Pneumology Department, Hospital Universitari Vall d’Hebron, Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 4AstraZeneca Pharmaceuticals, Moscow, Russian Federation; 5AstraZeneca LP, Gaithersburg, MD, USA
Background: The high prevalence of COPD in the Russian Federation has been demonstrated in several epidemiological studies. However, there are still no data on the clinical characteristics of these patients according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups and phenotypes, which could provide additional understanding of the burden of COPD, routine clinical practice, and ways to improve the treatment of patients with COPD in Russia.
Patients and methods: SUPPORT was an observational multicenter study designed to obtain data about the distribution of patients with previously diagnosed COPD according to the severity of bronchial obstruction, symptom severity, risk of exacerbation, COPD phenotypes, and treatment of COPD. We included patients with a previous diagnosis of COPD who visited one of 33 primary-care centers for any reason in 23 cities in Russia.
Results: Among the 1,505 patients with a previous diagnosis of COPD who attended the primary-care centers and were screened for the study, 1,111 had a spirometry-confirmed diagnosis and were included in the analysis. Up to 53% of the patients had severe or very severe COPD (GOLD stages III–IV), and 74.3% belonged to the GOLD D group. The majority of patients were frequent exacerbators (exacerbators with chronic bronchitis [37.3%], exacerbators without chronic bronchitis [14%]), while 35.8% were nonexacerbators and 12.9% had asthma–COPD overlap. Among the GOLD D group patients, >20% were treated with only short-acting bronchodilators.
Conclusion: COPD is still misdiagnosed in primary care in Russia. COPD patients in primary care are usually GOLD D with frequent exacerbations and are often treated with only short-acting bronchodilators.
Keywords: COPD, spirometry, observational study, Russian Federation, phenotypes
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