Perfil de los pacientes con enfermedad pulmonar obstructiva crónica tratados con broncodilatador dual en atención primaria (Estudio DUAL EPOC)

Abstract

Long acting bronchodilators are the basis for the drug treatment of chronic obstructive pulmonary disease (COPD). Dual bronchodilation (DB) with a beta-adrenergic (LABA) and an anticholinergic (LAMA) is of first choice in patients who continue with symptoms after monotherapy with any one of them. Objective. To know the clinical profile and cause of the initiation of DB in a single device in patients with COPD followed-up in primary care. Methods. A multicentric, observational and retrospective study. Demographic and clinical data (factors of risk, comorbidities, phenotype and symptoms at the initiation of DB) were used for the description of the profiles of the patients. Results. 2,120 patients were recruited: mean age 69.6 years; 73.2 % males; 44.7 % who were overweight and 32.2 % obese. The predominant clinical phenotypes were: non-exacerbator (34.2 %) and exacerbator with chronic bronchitis (29.2 %). Mean of the comorbidities was 2.09, with predominance of cardiovascular disorders followed by endocrine and psychological disorders (65.5 %, 31.4 % and 28.4 %, respectively). The most frequent causes for the introduction of DB were progressive increase of the dyspnea (1,246 patients; 558 with non-exacerbator phenotype), follow by the exacerbations (619 patients; 295 with exacerbator phenotype with chronic bronchitis). Conclusions. The principal motive to initiate treatment with dual bronchodilators (LABA/LAMA in a single device) in the collection of the patients studied was the increase of the dyspnea, although it was the increase of the exacerbations in the chronic bronchitis exacerbators.