Distribution and characteristics of COPD phenotypes – results from the Polish sub-cohort of the POPE study

Aleksander Kania,¹ Rafał Krenke,² Krzysztof Kuziemski,³ Małgorzata Czajkowska-Malinowska,⁴ Natalia Celejewska-Wójcik,¹ Barbara Kuźnar-Kamińska,⁵ Małgorzata Farnik,⁶ Juliusz Bokiej,⁷ Marta Miszczuk,² Iwona Damps-Konstańska,³ Marcin Grabicki,⁵ Marzena Trzaska-Sobczak,⁶ Krzysztof Sładek,¹ Halina Batura-Gabryel,⁵ Adam Barczyk<sup>6

1</sup>Department of Pulmonology, II Chair of Internal Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland; ²Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland; ³Department of Allergology and Pneumonology, Medical University of Gdańsk, Gdańsk, Poland; ⁴Department of Lung Diseases and Respiratory Failure, Regional Center of Pulmonology, Bydgoszcz, Poland; ⁵Department of Pulmonology, Allergology and Respiratory Oncology, Poznań University of Medical Sciences, Poznań, Poland; ⁶Department of Pneumology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland; ⁷Department of Lung Diseases, Regional Hospital Center Jelenia Góra, Jelenia Góra, Poland

Background: This study aimed to examine the distribution of predefined phenotypes, demographic data, clinical outcomes, and treatment of patients who were included in the Polish cohort of the Phenotypes of COPD in Central and Eastern Europe (POPE) study.
Patients and methods: This was a sub-analysis of the data from the Polish cohort of the POPE study, an international, multicenter, observational cross-sectional survey of COPD patients in Central and Eastern European countries. The study included patients aged .40 years, with a confirmed diagnosis of COPD, and absence of exacerbation for at least 4 weeks before study inclusion. A total of seven Polish centers participated in the study.
Results: Among the 430 Polish COPD patients enrolled in the study, 61.6% were non-exacerbators (NON-AE), 25.3% were frequent exacerbators with chronic bronchitis (AE CB), 7.9% were frequent exacerbators without chronic bronchitis (AE NON-CB), and 5.1% met the definition of asthma-COPD overlap syndrome (ACOS). There were statistically significant differences among these phenotypes in terms of symptom load, lung function, comorbidities, and treatment. Patients with the AE CB phenotype were most symptomatic with worse lung function, and more frequently reported anxiety and depression. Patients with the ACOS phenotype were significantly younger and were diagnosed with COPD earlier than those with other COPD phenotypes; those with the ACOS phenotype were also more often atopic and obese.
Conclusion: There is significant heterogeneity among COPD patients in the Polish population in terms of phenotype and clinical outcome. The non-exacerbator phenotype is observed most frequently in Poland, while the frequent exacerbator with chronic bronchitis phenotype is the most symptomatic.

Keywords: chronic obstructive pulmonary disease, asthma-COPD overlap syndrome, phenotypes