Long-term outcomes following first short-term clinically important deterioration in COPD.

ABSTRACT: BACKGROUND:Chronic obstructive pulmonary disease (COPD) is characterized by varying trajectories of decline. Information regarding the prognostic value of preventing short-term clinically important deterioration (CID) in lung function, health status, or first moderate/severe exacerbation as a composite endpoint of worsening is needed. We evaluated post hoc the link between early CID and long-term adverse outcomes. METHODS:CID was defined as ?100 mL decrease in forced expiratory volume in 1 s (FEV1), ?4-unit increase in St George's Respiratory Questionnaire (SGRQ) score from baseline, and/or a moderate/severe exacerbation during enrollment in two 3-year studies. Presence of CID was assessed at 6 months for the principal analysis (TORCH) and 12 months for the confirmatory analysis (ECLIPSE). Association between presence (+) or absence (-) of CID and long-term deterioration in FEV1, SGRQ, future risk of exacerbations, and all-cause mortality was assessed. RESULTS:In total, 2870 (54%; TORCH) and 1442 (73%; ECLIPSE) patients were CID+. At 36 months, in TORCH, CID+ patients (vs CID-) had sustained clinically significant worsening of FEV1 (-?117 mL; 95% confidence interval [CI]: -?134, -?100 mL; P?

SUBMITTER: Naya IP 

PROVIDER: S-EPMC6245880 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature