Search: onr:"swepub:oai:prod.swepub.kib.ki.se:144570544" >
Association between...
Association between COPD exacerbations and lung function decline during maintenance therapy
-
Kerkhof, M (author)
-
Voorham, J (author)
-
Dorinsky, P (author)
-
show more...
-
Cabrera, C (author)
-
Darken, P (author)
-
Kocks, JWH (author)
-
Sadatsafavi, M (author)
-
Sin, DD (author)
-
Carter, V (author)
-
Price, DB (author)
-
show less...
- 2020-06-12
- 2020
- English.
-
In: Thorax. - : BMJ. - 1468-3296 .- 0040-6376. ; 75:9, s. 744-753
- Related links:
-
https://thorax.bmj.c...
-
show more...
-
http://kipublication...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- Little is known about the impact of exacerbations on COPD progression or whether inhaled corticosteroid (ICS) use and blood eosinophil count (BEC) affect progression. We aimed to assess this in a prospective observational study.MethodsThe study population included patients with mild to moderate COPD, aged ≥35 years, with a smoking history, who were followed up for ≥3 years from first to last spirometry recording using two large UK electronic medical record databases: Clinical Practice Research Datalink (CPRD) and Optimum Patient Care Research Database (OPCRD). Multilevel mixed-effects linear regression models were used to determine the relationship between annual exacerbation rate following initiation of therapy (ICS vs non-ICS) and FEV1decline. Effect modification by blood eosinophils was studied through interaction terms.ResultsOf 12178 patients included (mean age 66 years; 48% female), 8981 (74%) received ICS. In patients with BEC ≥350 cells/µL not on ICS, each exacerbation was associated with subsequent acceleration of FEV1decline of 19.4 mL/year (95% CI 12.0 to 26.7, p<0.0001). This excess decline was reduced by 15.1 mL/year (6.6 to 23.6) to 4.3 mL/year (1.9 to 6.7, p<0.0001) in those with BEC ≥350 cells/µL treated with ICS.ConclusionExacerbations are associated with a more rapid loss of lung function among COPD patients with elevated blood eosinophils, defined as ≥350 cells/µL, not treated with ICS. More aggressive prevention of exacerbations using ICS in such patients may prevent excess loss of lung function.
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
-
Thorax
(Search for host publication in LIBRIS)
To the university's database
- By the author/editor
-
Kerkhof, M
-
Voorham, J
-
Dorinsky, P
-
Cabrera, C
-
Darken, P
-
Kocks, JWH
-
show more...
-
Sadatsafavi, M
-
Sin, DD
-
Carter, V
-
Price, DB
-
show less...
- Articles in the publication
-
Thorax
- By the university
-
Karolinska Institutet