COPD therapy based on clinical phenotypes: Baseline data from the Czech multicentre research database of COPD

Background: Several sets of guidelines, statements and strategies for managing and therapy of COPD exist around the world. Czech national COPD guideline defines 6 clinically relevant phenotypes and recommends therapy of COPD based on clinical phenotypes. Aim: The analysis of COPD therapy based on clinical phenotypes in the real practice. Methods: The Czech Multicentre Research Database of COPD (Database) is a multicenter, observational, and prospective study of patients with COPD and post bronchodilator FEV1≤60% (NCT01923051). Baseline data include the parameters used for identification of clinical phenotypes, and information about COPD therapy of each subject. Therapy strategies were analysed in accordance to clinical phenotypes and GOLD categories. Results: A total of 488 patients were enrolled into the Database. We found all six COPD phenotypes according to Czech COPD Guideline – bronchitic (bc) 75.5%, emphysematous (em) 77.4%, frequent exacerbators (ex) 34.7%, bronchiectatic (be) 28.4%, cachectic (ca) 16.3%, ACOS (acos) 4.2%. We found differences in treatment between phenotypes, including significantly higher use of mucoactive drugs in bc, ex, roflumilast in bc, ex, ICS+LABA in acos, long term antibiotic therapy in be, bronchoscopic lung volume reduction in em. There were also differences between COPD treatment based on clinical phenotypes and COPD treatment based on GOLD categories. Conclusion: 1st analysis of baseline data of the Database has confirmed the usefulness of phenotype-based therapy of COPD. Supported by IGA MZ CR NT/13560.