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Updated: May 12, 2026

Alternative Therapy for Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Moving Cupping Along Meridians
Published on: September 27, 2024
The EXACERBANTES Study (Exacerbation of Chronic Obstructive Pulmonary Disease According to the ANTES Proposal):
Juan José Soler-Cataluña1,2, Alberto Fernández-Villar3, José Luis Izquierdo4,5
1Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Departamento de Medicina, Universitat de València, Valencia, Spain.
Introduction:
COPD exacerbations (ECOPD) are complex events that demand a personalized approach. A novel patient-centered approach focuses on the identification of treatable traits (TTs) has recently been proposed.
Objectives:
The primary goal of the EXACERBANTES study is to systematically describe the distribution of TTs in patients with ECOPD attending primary care (PC) and hospital-based emergency care (HC). Secondary goals include: (1) assessing the relationship between individual TTs and relevant clinical outcomes; (2) developing a predictive risk score based on TTs; (3) comparing the performance of different severity classifications; (4) validating these scores against the DECAF (Dyspnea, Eosinopenia, Consolidation, Acidosis, Atrial Fibrillation) index in hospitalized patients; (5) evaluating the feasibility of measuring FEV1 during exacerbations using handheld microspirometers; and (6) comparing lung function during the acute phase with measurements taken 90 days later.
Material And Methods:
Prospective, multicenter, observational study involving patients diagnosed with ECOPD in PC and HC. The PC cohort will undergo routine and advanced testing including ECG, microspirometry, and capillary C-reactive protein (CRP). The HC cohort will undergo additional assessments such as blood tests, arterial blood gases, chest-X-test, and biomarkers (CRP, troponin T, NT-proBNP, D-dimer). Patients will be re-evaluated 90 days after the index event. The estimated sample size for the primary objective is 397 patients. The first patient was recruited on December 13, 2024; results are expected in the first quarter of 2026.
Conclusions:
The EXACERBANTES study offers a framework to explore TTs in ECOPD and to develop a personalized, outcome-oriented treatment strategy.
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