Evidence map›Paper›PMID 36219388›Full record

Observational studyAdvances in therapy2022

The Prescribing Practice for COPD: Relationship to Circadian Rhythm, Disease Severity, and Clinical Phenotype in the STORICO Observational Study.

Raffaele Antonelli Incalzi, Francesco Blasi, Giorgio Walter Canonica, Maria Pia Foschino, Renato Prediletto, Lucia Simoni, Alessandra Ori, Clara Giovannetti, Stefania Barsanti, Nicola Scichilone

Registry-linked trialAbstract readObservational StudyMulticenter Study
PubMed Publisher
In one paragraph

Observational study in Advances in therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03105999 (Observational Study On The Characterization Of 24-Hour Symptoms In Patients With COPD), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03105999 completednot on this map

Observational Study On The Characterization Of 24-Hour Symptoms In Patients With COPD

TypeobservationalSponsorLaboratori Guidotti S.p.A.Ran2016 to 2018Enrolled683ConditionsChronic Obstructive Pulmonary Disease
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Circadian rhythms and lung cancer biology and immunotherapy: Emerging opportunities and challenges.Chinese medical journal pulmonary and critical care medicine · 2026
    Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Raffaele Antonelli IncalziUniversity Biomedical Campus of Rome, Via Alvaro del Portillo, 21, 00128, Rome, Italy. R.Antonelli@unicampus.it.
Francesco BlasiInternal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20122, Milan, Italy.
Giorgio Walter CanonicaPersonalized Medicine Asthma and Allergy Clinic, Humanitas University Humanitas Research Hospital Rozzano (Milan), Via Manzoni, 56, 20089, Rozzano (Milan), Italy.
Maria Pia FoschinoMAR4 Univ., D'Avanzo Hospital, Viale degli Aviatori, 1, 71122, Foggia, Italy.
Renato PredilettoPneumology, Institute of Clinical Physiology, National Research Council of Italy and Toscana G. Monasterio Foundation, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy.
Lucia SimoniMedineos Observational Research, Viale Virgilio 54/U, 41123, Modena, Italy.
Alessandra OriMedineos Observational Research, Viale Virgilio 54/U, 41123, Modena, Italy.
Clara GiovannettiLaboratori Guidotti, Via Livornese, 897, 56122, Pisa, Italy.
Stefania BarsantiLaboratori Guidotti, Via Livornese, 897, 56122, Pisa, Italy.
Nicola ScichiloneDIBIMIS, University of Palermo, Piazza delle Cliniche, 2, 90127, Palermo, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWhile selected clinical and laboratory findings are taken into account to find the best therapeutic strategies for chronic obstructive pulmonary disease (COPD), it is unknown whether the circadian rhythm of respiratory symptoms, a distinctive feature of COPD, affects the prescription pattern of pharmacological therapy. The main aim of this study was to verify whether the circadian rhythm of symptoms correlates with bronchodilating therapy prescribed to COPD patients as per clinical practice. A secondary objective was to assess the relationship between Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage and circadian rhythm of symptoms and health status.

methodsFive hundred sixty-six COPD patients were enrolled in the Italian multicenter STORICO study. Patients underwent a multidimensional assessment, and correlates of prescribed therapy were assessed through a multivariate multilevel model.

resultsAs expected, patients in GOLD D stage were more likely to receive triple inhaled therapy than GOLD A-C patients, but the circadian rhythm of symptoms, assessed by the nighttime, morning, and daytime symptoms of the COPD questionnaire, was unrelated to the prescription pattern. The multivariate model showed that emphysematous (EM) patients had a 50% increased risk compared with patients affected by chronic bronchitis (CB) of being prescribed long-acting β2-agonists (LABA)/long-acting muscarinic antagonist (LAMA) fixed-dose combination (FDC) instead of triple therapy [relative risk (RR)

conclusionEven if we cannot infer about causality of the symptoms-therapy relationship, based on the structured recording of circadian symptoms clearly shows that symptoms are poorly controlled as the circadian rhythm of symptoms does not correlate with the prescription pattern, and many patients are symptomatic both at daytime and by nighttime. Thus, therapy should be better tailored to the individual needs, with special attention to control nocturnal symptoms.

trial registrationClinicalTrials.gov identifier, NCT03105999.

Indexed as

Adrenergic beta-2 Receptor AgonistsPulmonary Disease, Chronic ObstructiveAdministration, InhalationAdrenal Cortex HormonesBronchodilator AgentsCircadian RhythmDrug Therapy, CombinationHumansMuscarinic AntagonistsPhenotypeSeverity of Illness IndexAdrenal Cortex HormonesAdrenergic beta-2 Receptor AgonistsBronchodilator AgentsMuscarinic AntagonistsCircadian rhythmClinical phenotypeCOPDObservationalPrescribed therapiesReal-world

Identifiers

PMID36219388

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.