Spirometric changes during exacerbations of COPD: a post hoc analysis of the WISDOM trial

Published on Dec 13, 2018in Respiratory Research5.631
路 DOI :10.1186/S12931-018-0944-3
Henrik Watz38
Estimated H-index: 38
,
Kay Tetzlaff25
Estimated H-index: 25
(University of T眉bingen)
+ 5 AuthorsPeter M.A. Calverley88
Estimated H-index: 88
Sources
Abstract
Background Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with loss of lung function and poor outcomes for patients. However, there are limited data on the time course of changes in forced expiratory volume in 1 s (FEV1) preceding the first reported symptom and after the start of an exacerbation.
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#2Kay Tetzlaff (University of T眉bingen)H-Index: 25
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#1David M.G. Halpin (RD&E: Royal Devon and Exeter Hospital)H-Index: 30
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Abstract Background COPD exacerbations are associated with accelerated lung function decline, but whether they are causal is unknown. We evaluated the effect of a single exacerbation on rate of lung function change using data from the 4-year Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT 庐 ) trial. Methods Retrospective analysis of annual rates of decline in FEV 1 and FVC before and after a single (and the only) moderate-to-severe exacerbation in patients during UP...
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#2Gerard J. Criner (TU: Temple University)H-Index: 11
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This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 report focuses primarily on the revised and novel parts of the document. The most significant changes include: (1) the assessment of chronic obstructive pulmonary disease has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and...
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#2Ken M. Kunisaki (UMN: University of Minnesota)H-Index: 16
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Rationale: Acute exacerbations of chronic obstructive pulmonary disease (COPD) increase the risk of death and drive healthcare costs, but whether they accelerate loss of lung function remains controversial. Whether exacerbations in subjects with mild COPD or similar acute respiratory events in smokers without airflow obstruction affect lung function decline is unknown.Objectives: To determine the association between acute exacerbations of COPD (and acute respiratory events in smokers without COP...
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#1Roberto Rodriguez-Roisin (University of Barcelona)H-Index: 40
#2Kay Tetzlaff (University of T眉bingen)H-Index: 25
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The WISDOM study ({"type":"clinical-trial","attrs":{"text":"NCT00975195","term_id":"NCT00975195"}}NCT00975195) reported a change in lung function following withdrawal of fluticasone propionate in patients with severe to very severe COPD treated with tiotropium and salmeterol. However, little is known about the validity of home-based spirometry measurements of lung function in COPD. Therefore, as part of this study, following suitable training, patients recorded daily home-based spirometry measur...
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Summary Background Blood eosinophil counts might predict response to inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) and a history of exacerbations. We used data from the WISDOM trial to assess whether patients with COPD with higher blood eosinophil counts would be more likely to have exacerbations if ICS treatment was withdrawn. Methods WISDOM was a 12-month, randomised, parallel-group trial in which patients received 18 渭g tiotropium, 100 渭g salmeter...
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To the Editor: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition (1). The identification of COPD phenotypes may allow stratified treatment approaches that modulate discrete disease mechanisms. Peripheral blood eosinophilia is both a common and repeatable finding in COPD (2). In addition, the presence of a blood/sputum eosinophilia is associated with a significant proportion of COPD exacerbations (3, 4) and a favorable response to systemic steroids (5). However, the role o...
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#1Helgo MagnussenH-Index: 68
#2Henrik WatzH-Index: 38
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Summary Long-acting bronchodilators in combination with inhaled corticosteroids (ICS) are recommended to decrease the risk of recurrent exacerbations in patients with Global initiative for chronic Obstructive Lung Disease (GOLD) stage 3鈥4 chronic obstructive pulmonary disease (COPD). There is increasing concern about the clinical benefit and long-term safety of ICS use in COPD patients. The WISDOM (Withdrawal of Inhaled Steroids During Optimised bronchodilator Management) study (NCT00975195) aim...
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