Was haben wir aus der deutschen COPD-Kohorte COSYCONET gelernt und wie geht es weiter?

Kathrin Kahnert; Carolina Fischer; Peter Alter; Franziska Trudzinski; Tobias Welte; Jürgen Behr; Felix Herth; Hans-Ulrich Kauczor; Robert Bals; Henrik Watz; Klaus Rabe; Sandra Söhler; Inge Kokot; Claus Vogelmeier; Rudolf Jörres

doi:10.1055/a-1966-0848

Pneumologie, Table of Contents

CC BY-NC-ND 4.0 · Pneumologie 2023; 77(02): 81-93
DOI: 10.1055/a-1966-0848

Übersicht

Was haben wir aus der deutschen COPD-Kohorte COSYCONET gelernt und wie geht es weiter?

What have we learned from the German COPD cohort COSYCONET and where do we go from here?

Authors

Kathrin Kahnert

¹Medizinische Klinik und Poliklinik V, Klinikum der Universitat München LMU, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), München, Deutschland (Ringgold ID: RIN27192)
Carolina Fischer

²Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität München, München, Deutschland (Ringgold ID: RIN27192)
Peter Alter

³Klinik für Pneumologie, Philipps-Universitat Marburg, Member of the German Center for Lung Research (DZL), Marburg, Deutschland (Ringgold ID: RIN9377)
Franziska Trudzinski

⁴Thoraxklinik-Heidelberg gGmbH, Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Deutschland (Ringgold ID: RIN14996)
Tobias Welte

⁵Klinik für Pneumologie, Medizinische Hochschule Hannover, Member of the German Center of Lung Research (DZL), Hannover, Deutschland (Ringgold ID: RIN9177)
Jürgen Behr

¹Medizinische Klinik und Poliklinik V, Klinikum der Universitat München LMU, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), München, Deutschland (Ringgold ID: RIN27192)
Felix Herth

⁴Thoraxklinik-Heidelberg gGmbH, Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Deutschland (Ringgold ID: RIN14996)
Hans-Ulrich Kauczor

⁶Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Translational Lung Research Centre Heidelberg (TLRC), Member of the German Center for Lung Research, Heidelberg, Deutschland (Ringgold ID: RIN27178)
Robert Bals

⁷Innere Medizin V – Pulmonologie, Allergologie, Beatmungs-und Umweltmedizin, Universitätsklinikum des Saarlandes, Associated member of the Germen Center of Lung Research (DZL), Homburg, Deutschland (Ringgold ID: RIN39072)

⁸Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Deutschland (Ringgold ID: RIN9377)
Henrik Watz

⁹Pulmonary Research Institute, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Deutschland (Ringgold ID: RIN9213)
Klaus Rabe

⁹Pulmonary Research Institute, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf, Deutschland (Ringgold ID: RIN9213)

¹⁰Medizinische Fakultät, Christian-Albrechts Universität zu Kiel, Kiel, Deutschland (Ringgold ID: RIN98594)
Sandra Söhler

³Klinik für Pneumologie, Philipps-Universitat Marburg, Member of the German Center for Lung Research (DZL), Marburg, Deutschland (Ringgold ID: RIN9377)
Inge Kokot

³Klinik für Pneumologie, Philipps-Universitat Marburg, Member of the German Center for Lung Research (DZL), Marburg, Deutschland (Ringgold ID: RIN9377)
Claus Vogelmeier

³Klinik für Pneumologie, Philipps-Universitat Marburg, Member of the German Center for Lung Research (DZL), Marburg, Deutschland (Ringgold ID: RIN9377)
Rudolf Jörres

²Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität München, München, Deutschland (Ringgold ID: RIN27192)

Abstract

Zusammenfassung

COSYCONET 1 ist die derzeit einzige international konkurrenzfähige deutsche COPD-Kohorte. Die Rekrutierung begann Ende 2010 und endete im Dezember 2013. Sie resultierte in 2741 Patienten mit der Diagnose einer COPD, die in der Folge in regelmäßigen Visiten nachuntersucht wurden. Diese Visiten umfassten eine umfangreiche funktionelle und klinische Charakterisierung. Auf der Basis dieses hochwertigen Datensatzes war es möglich, eine Vielzahl klinischer Fragen zu beantworten. Diese reichten vom Verschreibungsverhalten über die genaue Analyse verschiedener Komorbiditäten, v.a. kardiovaskulärer Art, bis zu Biomarkern, radiologischen und gesundheitsökonomischen Analysen. Inzwischen wurden mehr als 60 Publikationen zu COSYCONET international veröffentlicht. Die nachstehende Arbeit liefert eine Übersicht über alle bislang erhaltenen Ergebnisse, mit einem besonderen Fokus darauf, deren wechselseitigen Zusammenhang sowie die möglichen praktischen Konsequenzen herauszuarbeiten. Ferner werden einige Informationen über die Folgestudie COSYCONET 2 gegeben.

Abstract

COSYCONET 1 is the only German COPD cohort which is large enough to be internationally comparable. The recruitment, which started in 2010 and ended in December 2013, comprised 2741 patients with the diagnosis of COPD who were subsequently investigated in regular follow-up visits. All visits included a comprehensive functional and clinical characterisation. On the basis of this detailed data set, it was possible to address a large number of clinical questions. These questions ranged from the prescription of medication, the detailed analysis of comorbidities, in particular cardiovascular disease, and biomarker assessment to radiological and health-economic aspects. Currently, more than 60 publications of COSYCONET data are internationally available. The present overview provides a description of all the results that were obtained, focussing on the relationship between different clinical and functional aspects as well as their potential practical consequences. In addition, information on the follow-up study COSYCONET 2 is given.

Schlüsselwörter

COPD - Komorbiditäten - Lungenfunktion - COPD-Therapie

Keywords

COPD - comorbidities - lung function - copd treatment

Full Text

References

Literatur
1 Jorres RA, Welte T, Bals R. et al. Systemic manifestations and comorbidities in patients with chronic obstructive pulmonary disease (COPD) and their effect on clinical state and course of the disease – an overview of the cohort study COSYCONET. Dtsch Med Wochenschr 2010; 135: 446-449
2 Lucke T, Herrera R, Wacker M. et al. Systematic Analysis of Self-Reported Comorbidities in Large Cohort Studies – A Novel Stepwise Approach by Evaluation of Medication. PLoS One 2016; 11: e0163408
3 Karch A, Vogelmeier C, Welte T. et al. The German COPD cohort COSYCONET: Aims, methods and descriptive analysis of the study population at baseline. Respir Med 2016; 114: 27-37
4 Agusti Vea. GLOBAL STRATEGY FOR PREVENTION, DIAGNOSIS AND MANAGEMENT OF COPD: 2022 Report. 2022
5 Ollenschlager G, Kopp I, Lelgemann M. The German Program for Disease Management Guidelines: COPD Guideline 2006. Short review. Med Klin (Munich) 2007; 102: 50-55
6 Graf J, Jorres RA, Lucke T. et al. Medical Treatment of COPD. Dtsch Arztebl Int 2018; 155: 599-605
7 Lutter JI, Jorres RA, Trudzinski FC. et al. Treatment of COPD Groups GOLD A and B with Inhaled Corticosteroids in the COSYCONET Cohort – Determinants and Consequences. Int J Chron Obstruct Pulmon Dis 2021; 16: 987-998
8 Konigsdorfer N, Jorres RA, Sohler S. et al. Adherence To Respiratory And Nonrespiratory Medication In Patients With COPD: Results Of The German COSYCONET Cohort. Patient Prefer Adherence 2019; 13: 1711-1721
9 Graf J, Lucke T, Herrera R. et al. Compatibility of medication with PRISCUS criteria and identification of drug interactions in a large cohort of patients with COPD. Pulm Pharmacol Ther 2018; 49: 123-129
10 Kahnert K, Jorres RA, Lucke T. et al. Lower Prevalence of Osteoporosis in Patients with COPD Taking Anti-Inflammatory Compounds for the Treatment of Diabetes: Results from COSYCONET. Int J Chron Obstruct Pulmon Dis 2021; 16: 3189-3199
11 Kahnert K, Lucke T, Biertz F. et al. Transfer factor for carbon monoxide in patients with COPD and diabetes: results from the German COSYCONET cohort. Respir Res 2017; 18: 14
12 Kahnert K, Andreas S, Kellerer C. et al. Reduced decline of lung diffusing capacity in COPD patients with diabetes and metformin treatment. Sci Rep 2022; 12: 1435
13 Hersh CP, Make BJ, Lynch DA. et al. Non-emphysematous chronic obstructive pulmonary disease is associated with diabetes mellitus. BMC Pulm Med 2014; 14: 164
14 Kahnert K, Lucke T, Huber RM. et al. Relationship of hyperlipidemia to comorbidities and lung function in COPD: Results of the COSYCONET cohort. PLoS One 2017; 12: e0177501
15 Divo M, Cote C, de Torres JP. et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012; 186: 155-161
16 Stone IS, Barnes NC, James WY. et al. Lung Deflation and Cardiovascular Structure and Function in Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial. Am J Respir Crit Care Med 2016; 193: 717-726
17 Hohlfeld JM, Vogel-Claussen J, Biller H. et al. Effect of lung deflation with indacaterol plus glycopyrronium on ventricular filling in patients with hyperinflation and COPD (CLAIM): a double-blind, randomised, crossover, placebo-controlled, single-centre trial. Lancet Respir Med 2018; 6: 368-378
18 Kellerer C, Kahnert K, Trudzinski FC. et al. COPD maintenance medication is linked to left atrial size: Results from the COSYCONET cohort. Respir Med 2021; 185: 106461
19 Rabe KF, Martinez FJ, Ferguson GT. et al. Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-Very-Severe COPD. N Engl J Med 2020; 383: 35-48
20 Alter P, Jorres RA, Watz H. et al. Left ventricular volume and wall stress are linked to lung function impairment in COPD. Int J Cardiol 2018; 261: 172-178
21 Alter P, Watz H, Kahnert K. et al. Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling. Respir Med 2018; 137: 14-22
22 Alter P, Watz H, Kahnert K. et al. Effects of airway obstruction and hyperinflation on electrocardiographic axes in COPD. Respir Res 2019; 20: 61
23 Alter P, Mayerhofer BA, Kahnert K. et al. Prevalence of cardiac comorbidities, and their underdetection and contribution to exertional symptoms in COPD: results from the COSYCONET cohort. Int J Chron Obstruct Pulmon Dis 2019; 14: 2163-2172
24 Trudzinski FC, Jorres RA, Alter P. et al. Sex-specific associations of comorbidome and pulmorbidome with mortality in chronic obstructive pulmonary disease: results from COSYCONET. Sci Rep 2022; 12: 8790
25 Trudzinski FC, Kellerer C, Jorres RA. et al. Gender-specific differences in COPD symptoms and their impact for the diagnosis of cardiac comorbidities. Clin Res Cardiol 2021;
26 Houben-Wilke S, Jorres RA, Bals R. et al. Peripheral Artery Disease and Its Clinical Relevance in Patients with Chronic Obstructive Pulmonary Disease in the COPD and Systemic Consequences-Comorbidities Network Study. Am J Respir Crit Care Med 2017; 195: 189-197
27 Kahnert K, Fohrenbach M, Lucke T. et al. The impact of COPD on polyneuropathy: results from the German COPD cohort COSYCONET. Respir Res 2020; 21: 28
28 Waschki B, Alter P, Zeller T. et al. High-sensitivity troponin I and all-cause mortality in patients with stable COPD: an analysis of the COSYCONET study. Eur Respir J 2020; 55: 1901314
29 Omlor AJ, Trudzinski FC, Alqudrah M. et al. Time-updated resting heart rate predicts mortality in patients with COPD. Clin Res Cardiol 2020; 109: 776-786
30 von Siemens SM, Jorres RA, Behr J. et al. Effect of COPD severity and comorbidities on the result of the PHQ-9 tool for the diagnosis of depression: results from the COSYCONET cohort study. Respir Res 2019; 20: 30
31 Kuhl K, Schurmann W, Rief W. Mental disorders and quality of life in COPD patients and their spouses. Int J Chron Obstruct Pulmon Dis 2008; 3: 727-736
32 Trudzinski FC, Jorres RA, Alter P. et al. Associations of oxygenated hemoglobin with disease burden and prognosis in stable COPD: Results from COSYCONET. Sci Rep 2020; 10: 10544
33 Hinke CF, Jorres RA, Alter P. et al. Prognostic Value of Oxygenated Hemoglobin Assessed during Acute Exacerbations of Chronic Pulmonary Disease. Respiration 2021; 100: 387-394
34 Kahnert K, Trudzinski FC, Berger C. et al. Oxygenated Hemoglobin Predicts Outcome in Patients with Chronic Lung Allograft Dysfunction. Respiration 2022; 101: 638-645
35 von Siemens SM, Perneczky R, Vogelmeier CF. et al. The association of cognitive functioning as measured by the DemTect with functional and clinical characteristics of COPD: results from the COSYCONET cohort. Respir Res 2019; 20: 257
36 Smid DE, Franssen FME, Gonik M. et al. Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease. J Am Med Dir Assoc 2017; 18: 1097 e1011-1097 e1024
37 Marietta von Siemens S, Alter P, Lutter JI. et al. CAT score single item analysis in patients with COPD: Results from COSYCONET. Respir Med 2019; 159: 105810
38 Kellerer C, Jorres RA, Schneider A. et al. Prediction of lung emphysema in COPD by spirometry and clinical symptoms: results from COSYCONET. Respir Res 2021; 22: 242
39 Kahnert K, Alter P, Young D. et al. The revised GOLD 2017 COPD categorization in relation to comorbidities. Respir Med 2018; 134: 79-85
40 Fahndrich S, Biertz F, Karch A. et al. Cardiovascular risk in patients with alpha-1-antitrypsin deficiency. Respir Res 2017; 18: 171
41 Keller A, Fehlmann T, Ludwig N. et al. Genome-wide MicroRNA Expression Profiles in COPD: Early Predictors for Cancer Development. Genomics Proteomics Bioinformatics 2018; 16: 162-171
42 Keller A, Ludwig N, Fehlmann T. et al. Low miR-150–5p and miR-320b Expression Predicts Reduced Survival of COPD Patients. Cells 2019; 8: 1162
43 Alter P, Orszag J, Kellerer C. et al. Prediction of air trapping or pulmonary hyperinflation by forced spirometry in COPD patients: results from COSYCONET. ERJ Open Res 2020; 6
44 Alter P, Rabe KF, Schulz H. et al. Influence of body mass on predicted values of static hyperinflation in COPD. Int J Chron Obstruct Pulmon Dis 2018; 13: 2551-2555
45 Alter P, Orszag J, Wouters EFM. et al. Differences in the Measurement of Functional Residual Capacity Between Body Plethysmographs of Two Manufacturers. Int J Chron Obstruct Pulmon Dis 2022; 17: 1477-1482
46 Kahnert K, Jobst B, Biertz F. et al. Relationship of spirometric, body plethysmographic, and diffusing capacity parameters to emphysema scores derived from CT scans. Chron Respir Dis 2019; 16: 1479972318775423
47 Kahnert K, Jorres RA, Kauczor HU. et al. Relationship between clinical and radiological signs of bronchiectasis in COPD patients: Results from COSYCONET. Respir Med 2020; 172: 106117
48 Kahnert W, Jörres RA, Jobst B. et al. Association of coronary artery calcification with clinical and physiological characteristics in patients with COPD: Results from COSYCONET. Respir Med. 2022; 204: 107014
49 Schiwek M, Triphan SMF, Biederer J. et al. Quantification of pulmonary perfusion abnormalities using DCE-MRI in COPD: comparison with quantitative CT and pulmonary function. Eur Radiol 2022; 32: 1879-1890
50 Triphan SMF, Weinheimer O, Gutberlet M. et al. Echo Time-Dependent Observed Lung T1 in Patients With Chronic Obstructive Pulmonary Disease in Correlation With Quantitative Imaging and Clinical Indices. J Magn Reson Imaging 2021; 54: 1562-1571
51 Kaireit TF, Voskrebenzev A, Gutberlet M. et al. Comparison of quantitative regional perfusion-weighted phase resolved functional lung (PREFUL) MRI with dynamic gadolinium-enhanced regional pulmonary perfusion MRI in COPD patients. J Magn Reson Imaging 2019; 49: 1122-1132
52 Triphan SMF, Biederer J, Burmester K. et al. Design and application of an MR reference phantom for multicentre lung imaging trials. PLoS One 2018; 13: e0199148
53 Mayerhofer B, Jorres RA, Lutter JI. et al. Deterioration and Mortality Risk of COPD Patients Not Fitting into Standard GOLD Categories: Results of the COSYCONET Cohort. Respiration 2021; 100: 308-317
54 Lommatzsch M, Speer T, Herr C. et al. IgE is associated with exacerbations and lung function decline in COPD. Respir Res 2022; 23: 1
55 Schunk SJ, Beisswenger C, Ritzmann F. et al. Measurement of urinary Dickkopf-3 uncovered silent progressive kidney injury in patients with chronic obstructive pulmonary disease. Kidney Int 2021; 100: 1081-1091
56 Greulich T, Mager S, Lucke T. et al. Longitudinal stability of blood eosinophil count strata in the COPD COSYCONET cohort. Int J Chron Obstruct Pulmon Dis 2018; 13: 2999-3002
57 Lutter JI, Jorres RA, Kahnert K. et al. Health-related quality of life associates with change in FEV1 in COPD: results from the COSYCONET cohort. BMC Pulm Med 2020; 20: 148
58 Wacker ME, Jorres RA, Karch A. et al. Assessing health-related quality of life in COPD: comparing generic and disease-specific instruments with focus on comorbidities. BMC Pulm Med 2016; 16: 70
59 Wacker ME, Jorres RA, Karch A. et al. Relative impact of COPD and comorbidities on generic health-related quality of life: a pooled analysis of the COSYCONET patient cohort and control subjects from the KORA and SHIP studies. Respir Res 2016; 17: 81
60 Trudzinski FC, Alqudrah M, Omlor A. et al. Consequences of chronic kidney disease in chronic obstructive pulmonary disease. Respir Res 2019; 20: 151
61 Trudzinski FC, Kahnert K, Vogelmeier CF. et al. Combined effects of lung function, blood gases and kidney function on the exacerbation risk in stable COPD: Results from the COSYCONET cohort. Respir Med 2019; 154: 18-26
62 Kahnert K, Alter P, Welte T. et al. Uric acid, lung function, physical capacity and exacerbation frequency in patients with COPD: a multi-dimensional approach. Respir Res 2018; 19: 110
63 Lutter JI, Jorres RA, Welte T. et al. Impact of Education on COPD Severity and All-Cause Mortality in Lifetime Never-Smokers and Longtime Ex-Smokers: Results of the COSYCONET Cohort. Int J Chron Obstruct Pulmon Dis 2020; 15: 2787-2798
64 Fischer C, Jörres RA, Alter P. And members of the COSYCONET study group. et al. Basic Determinants of Disease Knowledge in COPD Patients: Results from COSYCONET. Patient Prefer Adherence 2022; 16: 1759-1770
65 Lutter JI, Lukas M, Schwarzkopf L. et al. Utilization and determinants of use of non-pharmacological interventions in COPD: Results of the COSYCONET cohort. Respir Med 2020; 171: 106087
66 Kahnert K, Lutter JI, Welte T. et al. Impact of the COVID-19 pandemic on the behaviour and health status of patients with COPD: results from the German COPD cohort COSYCONET. ERJ Open Res 2021; 7
67 Wacker ME, Jorres RA, Schulz H. et al. Direct and indirect costs of COPD and its comorbidities: Results from the German COSYCONET study. Respir Med 2016; 111: 39-46
68 Wacker ME, Kitzing K, Jorres RA. et al. The contribution of symptoms and comorbidities to the economic impact of COPD: an analysis of the German COSYCONET cohort. Int J Chron Obstruct Pulmon Dis 2017; 12: 3437-3448
69 Byng D, Lutter JI, Wacker ME. et al. Determinants of healthcare utilization and costs in COPD patients: first longitudinal results from the German COPD cohort COSYCONET. Int J Chron Obstruct Pulmon Dis 2019; 14: 1423-1439
70 Karl FM, Holle R, Bals R. et al. Costs and health-related quality of life in Alpha-1-Antitrypsin Deficient COPD patients. Respir Res 2017; 18: 60