Susceptibility to Exacerbation in Chronic Obstructive Pulmonary Disease

摘要: BACKGROUND: Although we know that exacerbations are key events in chronic obstructive pulmonary disease (COPD), our understanding of their frequency, determinants, and effects is incomplete. In a large observational cohort, tested the hypothesis there frequent-exacerbation phenotype COPD independent severity. METHODS: We analyzed frequency associations exacerbation 2138 patients enrolled Evaluation Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study. Exacerbations were defined as led care provider prescribe antibiotics or corticosteroids (or both) hospitalization (severe exacerbations). Exacerbation was observed over period 3 years. RESULTS: became more frequent (and severe) severity increased; rates first year follow-up 0.85 per person for with stage 2 (with accordance Global Initiative Chronic Obstructive Lung Disease [GOLD] stages), 1.34 3, 2.00 4. Overall, 22% disease, 33% 47% 4 had (two follow-up). The single best predictor exacerbations, across all GOLD stages, history exacerbations. appeared be relatively stable years could predicted on basis patient's recall previous treated events. addition its association severe prior independently associated gastroesophageal reflux heartburn, poorer quality life, elevated white-cell count. CONCLUSIONS: become progresses, rate at which they occur appears reflect an susceptibility phenotype. This has implications targeting exacerbation-prevention strategies spectrum (Funded by GlaxoSmithKline; ClinicalTrials.gov number, NCT00292552.)