The EXACERBANTES Study (Exacerbation of Chronic Obstructive Pulmonary Disease According to the ANTES Proposal): Rationale, Goals and Design.

INTRODUCTION

COPD exacerbations (ECOPD) are complex events that demand a personalized approach. A novel patient-centered approach focuses on the identification of treatable traits (TTs) has recently been proposed.

OBJECTIVES

The primary goal of the EXACERBANTES study is to systematically describe the distribution of TTs in patients with ECOPD attending primary care (PC) and hospital-based emergency care (HC). Secondary goals include: (1) assessing the relationship between individual TTs and relevant clinical outcomes; (2) developing a predictive risk score based on TTs; (3) comparing the performance of different severity classifications; (4) validating these scores against the DECAF (Dyspnea, Eosinopenia, Consolidation, Acidosis, Atrial Fibrillation) index in hospitalized patients; (5) evaluating the feasibility of measuring FEV1 during exacerbations using handheld microspirometers; and (6) comparing lung function during the acute phase with measurements taken 90 days later.

MATERIAL AND

METHODS

Prospective, multicenter, observational study involving patients diagnosed with ECOPD in PC and HC. The PC cohort will undergo routine and advanced testing including ECG, microspirometry, and capillary C-reactive protein (CRP). The HC cohort will undergo additional assessments such as blood tests, arterial blood gases, chest-X-test, and biomarkers (CRP, troponin T, NT-proBNP, D-dimer). Patients will be re-evaluated 90 days after the index event. The estimated sample size for the primary objective is 397 patients. The first patient was recruited on December 13, 2024; results are expected in the first quarter of 2026.

CONCLUSIONS

The EXACERBANTES study offers a framework to explore TTs in ECOPD and to develop a personalized, outcome-oriented treatment strategy.