The PLATINO study: description of the distribution, stability, and mortality according to the Global Initiative for Chronic Obstructive Lung Disease classification from 2007 to 2017
Received 3 March 2017
Accepted for publication 19 April 2017
Published 18 May 2017 Volume 2017:12 Pages 1491—1501
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Ana M Menezes,1 Fernando C Wehrmeister,1 Rogelio Perez-Padilla,2 Karynna P Viana,3 Claudia Soares,3 Hana Müllerova,4 Gonzalo Valdivia,5 José R Jardim,6 Maria Montes de Oca7
1Federal University of Pelotas, Pelotas, Brazil; 2National Institute of Respiratory Diseases, Mexico City, Mexico; 3GlaxoSmithKline, Rio de Janeiro, Brazil; 4GlaxoSmithKline R&D, Stockley Park, UK; 5Pontificia Universidad Catolica de Chile, Santiago, Republic of Chile; 6Federal University of São Paulo, São Paulo, Brazil; 7Pulmonary Division, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) report provides a framework for classifying COPD reflecting the impacts of disease on patients and for targeting treatment recommendations. The GOLD 2017 introduced a new classification with 16 subgroups based on a composite of spirometry and symptoms/exacerbations.
Methods: Data from the population-based PLATINO study, collected at baseline and at follow-up, in three sites in Latin America were analyzed to compare the following: 1) the distribution of COPD patients according to GOLD 2007, 2013, and 2017; 2) the stability of the 2007 and 2013 classifications; and 3) the mortality rate over time stratified by GOLD 2007, 2013, and 2017.
Results: Of the 524 COPD patients evaluated, most of them were classified as Grade I or II (GOLD 2007) and Group A or B (GOLD 2013), with ≈70% of those classified as Group A in GOLD 2013 also classified as Grade I in GOLD 2007 and the highest percentage (41%) in Group D (2013) classified as Grade III (2007). According to GOLD 2017, among patients with Grade I airflow limitation, 69% of them were categorized into Group A, whereas Grade IV patients were more evenly distributed among Groups A–D. Most of the patients classified by GOLD 2007 remained in the same airflow limitation group at the follow-up; a greater temporal variability was observed with GOLD 2013 classification. Incidence-mortality rate in patients classified by GOLD 2007 was positively associated with increasing severity of airflow obstruction; for GOLD 2013 and GOLD 2017 (Groups A–D), highest mortality rates were observed in Groups C and D. No clear pattern was observed for mortality across the GOLD 2017 subgroups.
Conclusion: The PLATINO study data suggest that GOLD 2007 classification shows more stability over time compared with GOLD 2013. No clear patterns with respect to the distribution of patients or incidence-mortality rates were observed according to GOLD 2013/2017 classification.
Keywords: chronic obstructive lung diseases, Latin America, GOLD classification