Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2022 Aug;52(4):1130-1138.
doi: 10.55730/1300-0144.5416. Epub 2022 Aug 10.

Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study

Esra Ertan Yazar  1 , Burcu Arpınar Yiğitbaş  1 , Can Öztürk  2 , Mukadder Çalıkoğlu  3 , Gazi Gülbaş  4 , Muzaffer Onur Turan  5 , Hülya Şahin  6 , Nurhan Sarıoğlu  7 , Nevin Taci Hoca  8 , Fulsen Bozkuş  9 , Seda Tural Önür  10 , Nihal Arzu Mirici  11 , Nalan Ogan  12 , Nilgün Yılmaz Demirci  2 , Burcu Yormaz  13 , Ayperi Öztürk  8 , Filiz Koşar  10 , Evrim Eylem Akpınar  12 , Gülşah Günlüoğlu  10 , Burak Mete  14 , Mecit Süerdem  15
Affiliations
Observational Study

Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study

Esra Ertan Yazar et al. Turk J Med Sci. 2022 Aug.

Abstract

Background: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey.

Methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis.

Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV1 values were significantly higher in the ACO and NON-AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV1 ) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype.

Discussion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment.

Keywords: ACO; COPD; chronic bronchitis; emphysema; phenotype.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The centers and the number of patients participating in the study.
Figure 2
Figure 2
Distribution of phenotypes, GOLD stages and GOLD categories (A–D) in COPD patients. Abbreviations: NON-AE, nonexacerbators; AE NON-CB, frequent exacerbators without chronic bronchitis; AE-CB, frequent exacerbators with chronic bronchitis; COPD, chronic obstructive pulmonary disease; ACO, asthma-COPD overlap; GOLD, Global initiative for chronic obstructive lung disease; FEV1, forced expiratory volume in 1 s (% predicted).
Figure 3
Figure 3
Venn diagram of chronic obstructive pulmonary disease (COPD). The total number of patients 1107. ACO, asthma-COPD overlap.
See this image and copyright information in PMC

References

    1. Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, et al. BOLD Collaborative Research Group. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;370(9589):741–750. doi: 10.1016/S0140-6736(07)61377-4. Erratum in: Lancet 2012; 380(9844)806. - DOI - PubMed
    1. Özdemir T, Demirci NY, Kılıç H, Koç O, Kaya A, et al. An epidemiologic study of physician-diagnosed chronic obstructive pulmonary disease in the Turkish population: COPDTURKEY-1. Turkish Journal of Medical Sciences. 2020;50(1):132–140. doi: 10.3906/sag-1908-35. - DOI - PMC - PubMed
    1. Han MK, Agusti A, Calverley PM, Celli BR, Criner G, et al. Chronic obstructive pulmonary disease phenotypes: the future of COPD. American Journal of Respiratory and Critical Care Medicine. 2010;182(5):598–604. doi: 10.1164/rccm.200912-1843CC. - DOI - PMC - PubMed
    1. Calle Rubio M, Casamor R, Miravitlles M. Identification and distribution of COPD phenotypes in clinical practice according to Spanish COPD Guidelines: the FENEPOC study. International Journal of Chronic Obstructive Pulmonary Disease. 2017;12(1):2373–2383. doi: 10.2147/COPD.S137872. - DOI - PMC - PubMed
    1. Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, et al. American College of Physicians; American College of Chest Physicians; American Thoracic Society; European Respiratory Society. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals of Internal Medicine. 2011;155(3):179–191. doi: 10.7326/0003-4819-155-3-201108020-00008. - DOI - PubMed

Publication types