TY - JOUR
T1 - Factors associated with change in exacerbation frequency in COPD
AU - Donaldson, Gavin C.
AU - Müllerova, Hanna
AU - Locantore, Nicholas
AU - Hurst, John R.
AU - Calverley, Peter M.A.
AU - Vestbo, Jorgen
AU - Anzueto, Antonio
AU - Wedzicha, Jadwiga A.
N1 - Funding Information:
GlaxoSmithKline funded the ECLIPSE study. The authors conceived and planned the current analyses and were responsible for decisions with regard to publication. The study sponsor did not place any restrictions with regard to statements made in the final paper. GD has had support from GSK to attend Eclipse meetings; HM and NL are employees of GSK; JH has had support from GSK to attend Eclipse meetings and received payments for lectures; PC had had funding from GSK for the Eclipse study; meetings; membership of the scientific committees of TORCH, ECLIPSE and SUMMIT and for lectures; JV has received funding from GSK for consultancy for the COPD phase 2&3 program and for lectures, his wife previously worked for GSK; AA has received funding from GSK for consultancy, honoraria and lectures; JW has had funding from GSK for lectures, grants and board membership. The authors have all received funding from other pharmaceutical companies.
Funding Information:
This work was funded by GlaxoSmithKline. The authors acknowledge the principle investigators, steering and scientific committee of the ECLIPSE study. The authors would also like to thank the patients participating in the ECLIPSE study.
PY - 2013/7/30
Y1 - 2013/7/30
N2 - Background: Patients with chronic obstructive pulmonary disease (COPD) can be categorized as having frequent (FE) or infrequent (IE) exacerbations depending on whether they respectively experience two or more, or one or zero exacerbations per year. Although most patients do not change category from year to year, some will, and the factors associated with this behaviour have not been examined.Methods: 1832 patients completing two year follow-up in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study were examined at baseline and then yearly. Exacerbations were defined by health care utilisation. Patient characteristics compared between those patients who did or did not change exacerbation category from year 1 to year 2.Findings: Between years 1 and 2, 221 patients (17%) changed from IE to FE and 210 patients (39%) from FE to IE. More severe disease was associated with changing from IE to FE and less severe disease from FE to IE. Over the preceding year, small falls in FEV1 and 6-minute walking distance were associated with changing from IE to FE, and small falls in platelet count associated with changing from FE to IE.Conclusion: No parameter clearly predicts an imminent change in exacerbation frequency category.Trial registration: SCO104960, clinicaltrials.gov identifier NCT00292552.
AB - Background: Patients with chronic obstructive pulmonary disease (COPD) can be categorized as having frequent (FE) or infrequent (IE) exacerbations depending on whether they respectively experience two or more, or one or zero exacerbations per year. Although most patients do not change category from year to year, some will, and the factors associated with this behaviour have not been examined.Methods: 1832 patients completing two year follow-up in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) study were examined at baseline and then yearly. Exacerbations were defined by health care utilisation. Patient characteristics compared between those patients who did or did not change exacerbation category from year 1 to year 2.Findings: Between years 1 and 2, 221 patients (17%) changed from IE to FE and 210 patients (39%) from FE to IE. More severe disease was associated with changing from IE to FE and less severe disease from FE to IE. Over the preceding year, small falls in FEV1 and 6-minute walking distance were associated with changing from IE to FE, and small falls in platelet count associated with changing from FE to IE.Conclusion: No parameter clearly predicts an imminent change in exacerbation frequency category.Trial registration: SCO104960, clinicaltrials.gov identifier NCT00292552.
KW - COPD
KW - Exacerbation frequency
KW - Exacerbation phenotype
KW - Exacerbations
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U2 - 10.1186/1465-9921-14-79
DO - 10.1186/1465-9921-14-79
M3 - Article
C2 - 23899210
AN - SCOPUS:84881101135
SN - 1465-9921
VL - 14
JO - Respiratory research
JF - Respiratory research
IS - 1
M1 - 79
ER -