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    Chronic obstructive pulmonary disease phenotypes in Turkey: the COPET study-a national, multicenter cross-sectional observational study
    (Tubitak Scientific & Technological Research Council Turkey, 2022) Yazar, Esra Ertan; Yigitbas, Burcu Arpinar; Ozturk, Can; Calikoglu, Mukadder; Gulbas, Gazi; Turan, Muzaffer Onur; Sahin, Hulya
    Background/aim: While mortality rates decrease in many chronic diseases, it continues to increase in COPD. This situation has led to the need to develop new approaches such as phenotypes in the management of COPD. We aimed to investigate the distribution, characteristics and treatment preference of COPD phenotypes in Turkey. Materials and methods: The study was designed as a national, multicenter, observational and cross-sectional. A total of 1141 stable COPD patients were included in the analysis. Results: The phenotype distribution was as follows: 55.7% nonexacerbators (NON-AE), 25.6% frequent exacerbators without chronic bronchitis (AE NON-CB), 13.9% frequent exacerbators with chronic bronchitis (AE-CB), and 4.8% with asthma and COPD overlap (ACO). The FEV 1 values were significantly higher in the ACO and NON- AE than in the AE-CB and AE NON-CB (p < 0.001). The symptom scores, ADO (age, dyspnoea and FEV 1) index and the rates of exacerbations were significantly higher in the AE-CB and AE NON-CB phenotypes than in the ACO and NON-AE phenotypes (p < 0.001). Treatment preference in patients with COPD was statistically different among the phenotypes (p < 0.001). Subgroup analysis was performed in terms of emphysema, chronic bronchitis and ACO phenotypes of 1107 patients who had thoracic computed tomography. A total of 202 patients had more than one phenotypic trait, and 149 patients showed no features of a specific phenotype. Conclusion: Most of the phenotype models have tried to classify the patient into a certain phenotype so far. However, we observed that some of the patients with COPD had two or more phenotypes together. Therefore, rather than determining which phenotype the patients are classified in, searching for the phenotypic traits of each patient may enable more effective and individualized treatment.
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    COPET study findings regarding the clinical relevance of biomass exposure as an etiotype in COPD
    (Elsevier Science Inc, 2025) Yazar, Esra Ertan; Demirci, Nilgun; Yigitbas, Burcu Arpinar; Calikoglu, Mukadder; Gulbas, Gazi; Turan, Muzaffer Onur; Sahin, Hulya
    Purpose: The finding that COPD can also develop in non-smokers has led to further investigations of etiologic causes other than smoking. This study evaluated the relationship between tobacco smoking and/or biomass-burning smoke exposure (BBS) and the demographic, clinical, and prognostic characteristics of individuals with COPD. Methods; A total of 1129 stable COPD patients from the COPET study were retrospectively analyzed. The patients were divided into three groups: the COPD-B group (n = 52), which included patients who were solely BBS; the COPD-C group (n = 634), which included patients who exclusively tobacco smoking; and the COPD-BC group (n = 443), which included patients with both BBS and tobacco smoking. Results: The average age of the patients was 65.8 +/- 9.1 years, and 87.4 % of them were men. In the COPD-B group, the following factors were significantly greater compared to the COPD-C and COPD-BC groups: age (p = 0.001), BMI (p = 0.001), percentage of female patients (p < 0.001), FEV1/FVC ratio (p = 0.014), eosinophil count (p < 0.001), ADO score (p < 0.001), and the proportion of patients with frequent exacerbations (p = 0.013). Thorax CT scans showed that the COPD-BC group had a greater incidence of bronchiectasis and emphysema than the COPD-B and COPD-C groups (p < 0.001). Conclusions: This study highlights significant clinical and radiological differences among COPD patients based on tobacco smoking and BBS, which may substantially impact COPD outcomes, including exacerbations and prognosis.