Prospective assessment of GOLD 2017 categories and COPD phenotypesCzech Multicentre Research Database of COPD Group

Introduction:Currently, the Global Initiative for Chronic Obstructive Lung Disease released a revised consensus report (GOLD 2017).Moreover, some authors proposed subsequent grouping of COPD subjects into clinically meaningful phenotypes. Aim: Prospective assessment of real life evolution of GOLD 2017 categories and clinical phenotypes in the Czech Research Database of COPD. Methods: Subjects with severe COPD (FEV1≤60%) enrolled in this multicentre project were assessed annualy over the course of two years. Patients were stratified according to the previous (2016) and recent GOLD ABCD categories (2017) and according to predefined clinical phenotypes:non-exacerbators (NON-AE), asthmaCOPD overlap syndrome (ACOS), frequent exacerbators with (AE-CB) and without chronic bronchitis (AE NON-CB). Results: 784 COPD individuals (66 yrs, 73%males, FEV1 45±11.6%) were enrolled until Dec 2016.Of these, 292 were eligible with two-year follow-up data. The proportion of patients according to the 2016 and 2017 GOLD categories were A5%, B20%, C5%, D70%(GOLD 2016), and A8%, B53%, C2%, D37% (GOLD 2017), respectively, suggesting a substantial shift from patients from category D to B with the 2017 GOLD revision. Sixty-two% of the population were NON-AE, 18% were AE CB, 8% were AE NON-CB, and 12% were ACOS subjects. During three consecutive visits over the course of two years, 65% of the population remained stable with respect to their phenotypic classification, 61% were stable using the GOLD 2016 risk category classification, and 44% according to GOLD 2017 categories (p < 0.001). Conclusion: Phenotypic classification appeared to demonstrate largest stability over a period of 2 years.NCT01923051.