Phenotypes of Chronic Obstructive Pulmonary Disease (COPD)

· Article Review, COPD

Mufidatun Hasanah, Susanthy Djajalaksana


COPD is a complex syndrome with numerous pulmonary and extrapulmonary components with significant heterogeneity. The term phenotype in the field of COPD is defined as “a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes”. Among all phenotypes identified, there are three that are associated with prognosis and especially with a different response to currently available therapies. The phenotypes are mixed overlap COPD-asthma, the exacerbator, and the emphysema-hyperinflation. The exacerbator is characterized by the presence of, at least, two exacerbations in previous year, and on top of long-acting bronchodilators, may require anti-inflammatory drugs. The mixed overlap phenotype has symptoms related to the increased variability of airflow and incompletely reversible airflow obstruction. Due to the underlying inflammatory profile, this type have a good response to inhaled corticosteroids in addition to bronchodilators. The emphysema phenotype has a poor therapeutic response to the existing anti-inflammatory drugs with long-acting bronchodilators together with rehabilitation are the treatments of choice. Phenotyping in COPD is a relatively early endeavor. More efforts should be made to bring out international consensus statement on phenotypes-based management of COPD. (J Respir Indo. 2013; 33:271-9)

Keywords: COPD, phenotypes, clinical presentations, treatment

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