Predictors of Exacerbations Studied in Chronic Obstructive Pulmonary Disease

Predictors of Exacerbations Studied in Chronic Obstructive Pulmonary Disease

In a study recently presented during the 2015 American Thoracic Society International Conference , researchers from Brigham and Women’s Hospital in Boston found an association between exacerbations chronic obstructive pulmonary disease (COPD) and risk factors such as being female, having gastroesophageal reflux disease (GERD), and results on the St. George’s Respiratory Questionnaire (SGRQ). The study was conducted in COPD patients using long-acting controller medication.

“Knowing these factors can help clinicians identify subjects at risk for acute exacerbations of their COPD,” said Robert Busch, MD, Brigham and Women’s Hospital, Boston in a recent news release.

According to Dr. Busch, while inhaled medications lessen exacerbations in some patents, others still suffer from them. As part of the COPDGene study, an investigation of the genetic factors associated with COPD, the team of investigators sought to understand risk factors associated with the risk of acute exacerbations (AE).

The researchers included 2,489 COPD patients taking tiotropium (TIO), long-acting beta-agonist inhaled corticosteroids (LABA/ICS), and/or short-acting bronchodilators (SAB) alone or in combination. Patients were assigned into one of four different medication user groups: TIO/LABA/ICS, TIO, LABA/ICS, and SAB).

To identify patients with a history of exacerbations and those ”nonexacerbators,” the team of researchers used the frequency of AECOPD (one or more AECOPD a year compared with zero AECOPD for nonexacerbators).

Results revealed that in the group of patients that used multiple drugs, female gender, the presence of GERD, and higher total SGRQ scores were all predictors of exacerbation status. Results also showed that those patients in the group under medication with LABA/ICS or TIO showed similar characteristics, including percent emphysema by CT scan forced expiratory volume in one second, pack-years of smoking and 6-minute walk distance.

The researchers also found that patients in the TIO group had lower rates of exacerbations in comparison with those patients that being treated with LABA/ICS.

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