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COPD 2022

Daniela Cardoso

Daniela Cardoso, Speaker at COPD Conferences 2022
CHUC, Portugal
Title : Treatable traits in COPD: Differences between GOLD-classes.


Introduction: The classification and management of COPD are currently based on a patient-centric approach, emphasising the importance of symptoms and exacerbation history (GOLD-classes). Since COPD patients present hight individual heterogeneity, the treatable traits (TT) strategy has been proposed as a further personalized method, identifying therapeutic targets trough treat identification markers (TIM).

Objectives: Identify and compare TT between GOLD-classes on a COPD patients’ population.

Methods: 22 TT and respective TIMs were defined. Retrospective study of COPD patients followed in a specialized consultation on a tertiary hospital, during 2021 first semester. Descriptive and comparative analysis was made between different GOLD classes, using SPSS program.

Results: Totally, 128 patients were studied, with a median age of 72.5 years old and male predominance (82%). The majority belonged to Class B (56.3%), followed by classes D (22.7%), A (15.6%) and C (5.5%). There was a statistically significant difference in the mean number of TT found in each GOLD class (p=0.007): 7.28 TT in class D, 6.49 in B, 5.1 in A and 4.7 in C. The least researched or registered TT were: osteoporosis (97.7%), GERD (71.9%), SAS (54.7%) and depression (52.3%). In class-D patients (n=29), the TTs found in most patients (>50%) were: desaturation in exertion (88.9%), eosinophilic airway inflammation (79.3%), cardiovascular disease (CVD | 76%), respiratory failure (RF | 72.4%), depression (66.7%), sleep apnea syndrome (SAS | 66.7%), emphysema (65.4%), exercise intolerance (61.1%) and bronchitis (58.6%). Within class B (n=72) were: emphysema (74.6%), SAS (75%), CVD (72.9%), depression/anxiety (72.2%), eosinophilic airway inflammation (62.2%), exercise intolerance (60.8%), gastroesophageal reflux disease (GERD | 55.6%) and desaturation in exertion (54%). In class A (n=20) most patients were found with: SAS (90%), emphysema (80%), eosinophilic airway inflammation (56.3%) and cardiovascular disease (56.3%%). Most class C patients (n=7) presented: depression/anxiety (100%), airway eosinophilic inflammation (85.7%), GERD and SAS (66.7%) and bronchiectasis (BQ | 57.1%). A statistically significant difference between GOLD classes was found in the presence of several TT: respiratory failure (p=0.003), desaturation (p=0.006) and effort intolerance (p=0.014), which were more prevalent in classes B and D, and also, bronchiectasis (p=0.01), more prevalent in classes A and C. 

Conclusions: The symptomatic GOLD groups (B and D) present a higher number of TT, outlining a wider therapeutic window. These groups showed a higher prevalence of RF, exercise intolerance and desaturation at exertion, with statistical significance. The less symptomatic groups (A and C), showed a statistically significant higher prevalence of BQ. Associated extrapulmonary comorbidities were the least researched or recorded TT.


Cardoso J, Ferreira AJ, Guimarães M, Oliveira AS, Simão P, Sucena M. Treatable Traits in COPD - A Proposed Approach. Int J Chron Obstruct Pulmon Dis. 2021 Nov 18;16:3167-3182. doi: 10.2147/COPD.S330817. PMID: 34824530; PMCID: PMC8609199.