&lt;p&gt;Clinical burden of illness among patients with severe eosinophilic COPD&lt;/p&gt;

Müllerová, Hana; Meeraus, Wilhelmine; Galkin, Dmitry; Albers, Frank C.; Landis, Sarah H.

doi:10.2147/copd.s194511

Cited by 10 publications

(12 citation statements)

References 43 publications

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“…12 (6%) studies compared those with high versus low blood eosinophil counts or concentrations, although the thresholds used to determine high and low differed by study ( supplementary table S8 ) [ 13 – 15 ]. Three studies performed sensitivity analyses to examine the effect of using differing thresholds [ 16 – 18 ]. Eight (4%) studies categorised individuals by their GOLD groups ( i.e.…”

Section: Resultsmentioning

confidence: 99%

Identifying COPD in routinely collected electronic health records: a systematic scoping review

et al. 2021

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Although routinely collected electronic health records (EHR) are widely used to examine outcomes related to chronic obstructive pulmonary disease (COPD), consensus regarding the identification of cases from electronic healthcare databases is lacking. We systematically examine and summarise approaches from the recent literature.MEDLINE via EBSCOhost was searched for COPD-related studies using EHR published from January 1, 2018 to November 30, 2019. Data were extracted relating to the case definition of COPD and determination of COPD severity and phenotypes.From 185 eligible studies, we found widespread variation in the definitions used to identify people with COPD in terms of code sets used (with 20 different code sets in use based on the ICD-10 classification alone) and requirement of additional criteria (relating to age (n=139), medication (n=31), multiplicity of events (n=21), spirometry (n=19) and smoking status (n=9)). Only 7 studies used a case definition which had been validated against a reference standard in the same dataset. Various proxies of disease severity were used since spirometry results and patient-reported outcomes were not often available.To enable the research community to draw reliable insights from electronic health records and aid comparability between studies, clear reporting and greater consistency of the definitions used to identify COPD and related outcome measures is key.

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Section: Resultsmentioning

confidence: 99%

Identifying COPD in routinely collected electronic health records: a systematic scoping review

et al. 2021

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“…There might be confusion that COPD with symptom variability is a type of asthma-COPD overlap (ACO). However, it is conceivable that the variable group showed characteristics distinguishable from ACO by demonstrating no significant differences in asthmatic features, such as family history of asthma, comorbidity, bronchodilator response of FEV 1 (data were not shown in the result), and blood eosinophils 19,20. In addition, the variable group is not a population of symptom worsening because the decline in SGRQ scores did not differ according to symptom variability.…”

Section: Discussionmentioning

confidence: 88%

<p>Impact of symptom variability on clinical outcomes in COPD: analysis of a longitudinal cohort</p>

Kim¹,

Suh²,

Park³

et al. 2019

COPD

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PurposeWe compared clinical characteristics of COPD patients according to symptom variability and evaluated the effect of symptom variability during the first year of enrollment on clinical outcomes of COPD.MethodsWe analyzed COPD patients’ data from the Korean Obstructive Lung Disease (KOLD) cohort. Symptom variability was defined based on the value of standard deviation (SD) of mMRC scores obtained every 3 months during the follow-up period of the first year. Patients were divided into 2 groups: the consistent (SD of mMRC scores =0) and variable (SD of mMRC scores >0) groups. Clinical characteristics and outcomes were compared in terms of symptom variability.ResultsA total of 407 patients were included in the analysis. Patient age was 67.2 years and 97.8% of the subjects were male. Initial mMRC was 1.5 and the SD of mMRC scores during the first year was 0.5. There were 137 subjects (33.7%) in the consistent group and 270 (66.3%) in the variable group. The variable group showed a lower FEV1 (P=0.019) and a higher mMRC score (P=0.001). The annual incidence of acute exacerbation of COPD (AE-COPD) tended to be higher in the variable group (P=0.078) and that of severe AE-COPD was higher in the variable group than in the consistent group (P=0.002). The variable group showed a higher proportion of annual exacerbators (P=0.001) and frequent exacerbators (P=0.017). In multivariate logistic regression analysis, the variable group was significantly associated with annual exacerbators (OR =1.963, P=0.011) and frequent exacerbators (OR =2.090, P=0.055).ConclusionCOPD patients with symptom variability may have higher exacerbation risk as well as lower lung function and more severe respiratory symptoms.

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“…To obtain a representative sample of patients with severe exacerbating COPD treated with triple therapy, the necessary number of patients was calculated according to the estimated prevalence of Spanish patients with severe COPD (5.2% according to the EPI-SCAN study) 28 and the mean proportion of these with eosinophils ≥ 150 cells/µL (estimated at between 40% and 60%). 29,30 Given this data and a 95% confidence interval, a 2% precision, and a reposition percentage of 10%, an estimate of 250 patients with ≥150 cells/µL was needed. Similarly, the adequate number of patients with <150 cell/µL needed to evaluate secondary objectives was 104, considering the prevalence of patients with severe COPD in Spain already cited and an estimated proportion of patients with these eosinophil values of approximately 40%.…”

Section: Sample Sizementioning

confidence: 99%

Burden of Disease Among Exacerbating Patients with COPD Treated with Triple Therapy in Spain

Alcázar¹,

García‐Río²,

Sánchez³

et al. 2021

COPD

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Background:The cost of chronic obstructive pulmonary disease (COPD) in Spain has been studied from different perspectives, but parameters such as the patient's phenotype have seldom been considered. Our aim was to describe the disease burden of COPD patients with frequent exacerbator phenotype, treated with triple therapy. Methods: An observational, multicenter study was carried out from December 2017 to November 2018 in pulmonology services among patients ≥40 years with COPD confirmed diagnosis receiving triple therapy (ICS/LAMA/LABA) and history of ≥2 moderate or ≥1 severe exacerbation in the 12 months prior to the inclusion visit. COPD-related healthcare resources were collected over a 12-months period prior to the inclusion visit: pharmacological and non-pharmacological treatments, medical and ER visits, hospitalizations, tests and productivity loss. Costs were updated to €2019. Patients were classified according to blood eosinophil levels: <150 cells/µL and ≥150 cells/µL. Results: A total of 306 patients were included (77.1% men), with mean age of 69.9 years. Mean COPD exacerbation rate was 2.5/patient/year and 51.3% of patients had ≥150 cells/µL eosinophil level. On average, for the total population, COPD-related visits/patients/year were 6.2. Resource use in moderate exacerbation was higher in patients with eosinophils ≥150 cells/µL, whereas in severe exacerbation was higher in patients with eosinophils <150cells/ µL. According to eosinophil levels, total annual mean (SD) costs/patient accounted for €8382 (9863) and €5144 (5444) for patients with eosinophils <150 cells/µL and ≥150 cells/µL, respectively. Conclusion:The impact of exacerbating COPD patients treated with triple therapy in Spain is large, especially among those with eosinophils <150 cells/µL.

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<p>Clinical burden of illness among patients with severe eosinophilic COPD</p>

Cited by 10 publications

References 43 publications

Identifying COPD in routinely collected electronic health records: a systematic scoping review

Identifying COPD in routinely collected electronic health records: a systematic scoping review

<p>Impact of symptom variability on clinical outcomes in COPD: analysis of a longitudinal cohort</p>

Burden of Disease Among Exacerbating Patients with COPD Treated with Triple Therapy in Spain

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