Prevalence and impact of respiratory symptoms in a population of patients with COPD in Latin America: The LASSYC observational study

Miravitlles, Marc; Menezes, Ana Maria Baptista; Varela, María Victorina López; Casas, Alejandro; Ugalde, Luis Carlos; Ramírez‐Venegas, Alejandra; Mendoza, Laura; López, Ana Marı́a; Wehrmeister, Fernando César; Surmont, Filip; de, María Montes

doi:10.1016/j.rmed.2017.11.018

Cited by 13 publications

(25 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding is in line with the observation of high symptom variability within levels of disease severity, 29 and high short-term variability in symptoms that is not due to changes in lung function. 4,12 Our results extend these previous studies by examining the role of FEV 1 in each symptom individually. They suggest that lung function is the primary driver of the occurrence of phlegm, an important but not dominant driver of the occurrence of dyspnea and any symptoms, but it explains very little between-individual variation in the occurrence of cough and wheeze.…”

Section: Discussionsupporting

confidence: 87%

“…2 The degree of symptom impairment is increasingly recognized as an important determinant of patient management strategies, and one that is only partially dependent on the severity of airflow limitation. 4,7,11,12 Indeed, modern guidelines such as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) appreciate the importance of all three components in disease management decisions. The GOLD guidelines recommend evaluating symptoms separately from airflow limitation and history of exacerbations in providing therapeutic recommendations.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Heterogeneity in the respiratory symptoms of patients with mild-moderate COPD

Johnson

Safari

Tan

et al. 2018

Preprint

View full text Add to dashboard Cite

1Background: The burden of symptoms varies markedly between patients with Chronic 2 Obstructive Pulmonary Disease (COPD) and is only weakly correlated with lung function 3 impairment. While heterogeneity in lung function decline and exacerbations have been 4 previously studied, the extent of heterogeneity in symptoms and the factors associated with this 5 heterogeneity are not well understood. 6 Methods: A sample of the general Canadian population ≥ 40 years with persistent airflow 7 limitation was followed for up to 3 years. Participants reported whether they experienced chronic 8 coughing, phlegm, wheezing, or dyspnea during visits at 18-month intervals. We used mixed-9 effect logistic regression models (separately for each symptom) to assess overall heterogeneity in 1 0 the occurrence of symptoms between individuals, and the proportion of variation in symptom 1 1 burden explained by lung function versus all other clinical characteristics of participants. 1 2 Results: 548 participants (54% male, mean age 67 years) contributed 1,086 visits in total, and 1 3 82% of patients reported at least one symptom during follow-up. There was substantial 1 4 heterogeneity in the individual-specific probabilities for the occurrence of symptoms. This 1 5 heterogeneity was highest for dyspnea and lowest for phlegm (interquartile range of 1 6 probabilities: 0.15-0.77 and <0.01-0.53, respectively). FEV 1 explained 82% of the variation 1 7between individuals in the occurrence of phlegm, 26% for dyspnea, 3% for cough, and <0.1% for 1 8 wheeze. All clinical characteristics of participants (including FEV 1 ) explained between 86% of 1 9 heterogeneity in the occurrence of phlegm to <1% for wheeze. 2 0 Conclusion: There is marked heterogeneity in the burden of respiratory symptoms between 2 1 COPD patients. The ability of lung function and other commonly measured clinical 2 2characteristics to explain this heterogeneity differs between symptoms. 2 3 2 4 3 Word count: 262 2 5 2 6

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Heterogeneity in the respiratory symptoms of patients with mild-moderate COPD

Johnson

Safari

Tan

et al. 2018

Preprint

View full text Add to dashboard Cite

show abstract

“…The Latin American Study of 24-hour Symptoms in Chronic Obstructive Pulmonary Disease (LASSYC) was a prospective observational, multicenter, multinational, cross-sectional, non-interventional study in stable COPD patients from seven Latin American countries: Argentina, Chile, Colombia, Costa Rica, Guatemala, Mexico, and Uruguay. 11 , 12 The study has been registered at ClinicalTrials.gov (identifier: NCT02789540). Here, we analyzed prescribed medication use and adherence to different inhaled therapies in this patient population.…”

Section: Methodsmentioning

confidence: 99%

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

Casas¹,

de²,

Menezes³

et al. 2018

COPD

Self Cite

View full text Add to dashboard Cite

BackgroundLimited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region.MethodsThis was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other.ResultsIn total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire.ConclusionCOPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence.

show abstract

“…These patients were mostly women with more severe COPD in terms of lung function and BODEx, and who were more inactive and presented more exacerbations. 19 …”

Section: Discussionmentioning

confidence: 99%

Evaluating the impact of morning symptoms in COPD using the Capacity of Daily Living during the Morning (CDLM) questionnaire

Núñez

Esquinas

Barrecheguren

et al. 2018

COPD

Self Cite

View full text Add to dashboard Cite

PurposeThe aim of this study was to evaluate the impact of morning symptoms in COPD using the Capacity of Daily Living during the Morning (CDLM) questionnaire and to determine the clinical variables that are related to CDLM scores.MethodsThis was an observational, cross-sectional, and multicenter study conducted in stable COPD patients. CDLM scores ranged from 0 to 5 and were transformed into a qualitative variable according to tertile values to compare patient characteristics. A multivariate linear regression model was used to identify the clinical variables related to CDLM scores.ResultsA total of 605 patients were included in the study; the mean age (SD) was 68 years (9.1) and mostly were male (80.8%). The mean post-bronchodilator FEV1% was 53.4% (19.2%), and the mean BODEx (body mass index, airway obstruction, dyspnea, exacerbation) score was 3.2 (2.0). The mean COPD assessment test (CAT) score was 16.6 (8.3), and the mean CDLM score was 4.2 (0.9). First tertile patients, that is, those with a higher impact in the morning, were older, had more respiratory symptoms, more dyspnea, a lower FEV1%, lower CAT and BODEx scores, and more exacerbations. We found a ceiling effect on the CDLM scores: 194 (32%) patients scored 5.00 and no patients scored 0. On multivariate analysis, higher CAT and BODEx scores, a lower FEV1%, and use of long-term oxygen therapy (LTOT) were all independently related to lower CDLM scores.ConclusionMorning respiratory symptoms are associated with more severe airflow obstruction, lower CAT and BODEx scores, and LTOT. The ceiling effect of the CDLM questionnaire does not allow it to discriminate well between low and high impact of morning symptoms.

show abstract

Prevalence and impact of respiratory symptoms in a population of patients with COPD in Latin America: The LASSYC observational study

Abstract: NCT02789540.

Cited by 13 publications

References 44 publications

Heterogeneity in the respiratory symptoms of patients with mild-moderate COPD

Heterogeneity in the respiratory symptoms of patients with mild-moderate COPD

Respiratory medication used in COPD patients from seven Latin American countries: the LASSYC study

Evaluating the impact of morning symptoms in COPD using the Capacity of Daily Living during the Morning (CDLM) questionnaire

Contact Info

Product

Resources

About