RT info:eu-repo/semantics/article
T1 COPD Clinical Control: predictors and long-term follow-up of the CHAIN cohort
A1 Casanova Macario, Ciro
A1 Calle Rubio, Myriam
A1 Rodríguez Hermosa, Juan Luis
A1 de Torres, Juan P.
A1 Marín, José María
A1 Martínez‑González, Cristina
A1 Fuster, Antonia
A1 Cosío, Borja G.
A1 Peces‑Barba, Germán
A1 Solanes, Ingrid
A1 Feu‑Collado, Nuria
A1 López‑Campos, José Luis
A2 Grupo de investigación sobre la enfermedad pulmonar obstructiva crónica (EPOC). Unidad de Investigación del Hospital Universitario La Candelaria.
K1 Chronic obstructive pulmonary disease
K1 Control
K1 Management
AB BACKGROUND: Control in COPD is a dynamic concept that can reflect changes in patients' clinical status that may have prognostic implications, but there is no information about changes in control status and its long-term consequences. METHODS: We classified 798 patients with COPD from the CHAIN cohort as controlled/uncontrolled at baseline and over 5 years. We describe the changes in control status in patients over long-term follow-up and analyze the factors that were associated with longitudinal control patterns and related survival using the Cox hazard analysis. RESULTS: 134 patients (16.8%) were considered persistently controlled, 248 (31.1%) persistently uncontrolled and 416 (52.1%) changed control status during follow-up. The variables significantly associated with persistent control were not requiring triple therapy at baseline and having a better quality of life. Annual changes in outcomes (health status, psychological status, airflow limitation) did not differ in patients, regardless of clinical control status. All-cause mortality was lower in persistently controlled patients (5.5% versus 19.1%, p = 0.001). The hazard ratio for all-cause mortality was 2.274 (95% CI 1.394-3.708; p = 0.001). Regarding pharmacological treatment, triple inhaled therapy was the most common option in persistently uncontrolled patients (72.2%). Patients with persistent disease control more frequently used bronchodilators for monotherapy (53%) at recruitment, although by the end of the follow-up period, 20% had scaled up their treatment, with triple therapy being the most frequent therapeutic pattern. CONCLUSIONS: The evaluation of COPD control status provides relevant prognostic information on survival. There is important variability in clinical control status and only a small proportion of the patients had persistently good control. Changes in the treatment pattern may be relevant in the longitudinal pattern of COPD clinical control. Further studies in other populations should validate our results. TRIAL REGISTRATION: Clinical Trials.gov: identifier NCT01122758.
SN 1465-993X
YR 2021
FD 2021
LK http://riull.ull.es/xmlui/handle/915/35755
UL http://riull.ull.es/xmlui/handle/915/35755
LA en
DS Repositorio institucional de la Universidad de La Laguna
RD 21-may-2024