Deconstructing Phenotypes in COPD: an Analysis of the TRACE Cohort

Area of Science:

• Pulmonology
• Clinical Medicine
• Respiratory Diseases

Background:

• Clinical phenotype-based management is crucial for COPD.
• The Spanish COPD guidelines (GesEPOC) aim to categorize patients into distinct phenotypes.
• Ensuring exclusive single-phenotype assignment is ideal for effective COPD management.

Purpose of the Study:

• To evaluate if GesEPOC exclusively assigns COPD patients to one phenotype.
• To analyze the criteria defining GesEPOC phenotypes.
• To assess phenotype distribution and criteria application in high- and low-risk COPD patients.

Main Methods:

• Prospective cohort study (TRACE; NCT03485690) of 970 COPD patients since 2012.
• Analysis of GesEPOC phenotype assignment and defining criteria.
• Comparison of phenotype distribution between low- and high-risk groups.

Main Results:

• 55.9% of patients were high-risk, 44.02% were low-risk.
• 9.2% of patients met no phenotype criteria; 19.1% met criteria for two phenotypes.
• 20.6% of low-risk patients had asthma-COPD overlap syndrome.

Conclusions:

• The current GesEPOC clinical phenotype strategy has weaknesses.
• Overlapping phenotype categories and unassigned patients were observed.
• Improvements are needed for exclusive single-phenotype assignment in COPD management.