Phenotypes of chronic obstructive pulmonary disease and approaches to treatment of acute exacerbations of COPD in Russian Federation: results of non-interventional study CLOUD
The objective of this study was to describe pharmacological management (including different schemes of glucocorticoid therapy) of patients with severe and very severe COPD, management of acute exacerbation of COPD (AECOPD) and causes of change in the therapy. Methods. This was an observational multicenter descriptive study. The study involved 1,029 patients admitted to a hospital due to AECOPD. Demographic, social and economic data and patients’ distribution to clinical phenotypes according to the Czech classification, history of COPD, serious comorbidity, pharmacotherapy for COPD, smoking status, occupational history, health status and quality of life were analyzed. Results. Phenotypes of chronic bronchitis and of frequent exacerbator were the most common. There were 795 patients (77.26%) with stage 3 COPD and 234 patients (22.66%) with stage 3 COPD in the population involved. About 95% patients were treated in line with GOLD, 2014. Three months after hospital discharge, therapy with inhaled corticosteroids (ICS) was changed in 89 patients (10.45%), mostly due to an acute exacerbation of COPD (about 29%), followed by a high cost of the drugs (25.4%) and non-reimbursable drugs (21%). Conclusion. Pharmacological therapy was guideline-adherent in majority of patients with severe and very severe. ICS as single therapy or in fixed combinations with long-acting beta-agonists comprised a significant part of treatment in those patients. Therapy was change during 12 months after hospital discharge in 59% of patients.