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DOI: 10.1055/s-0037-1598544
Assessing COPD profiles and outcomes by dyspnoea severity
Publication History
Publication Date:
23 February 2017 (online)
Introduction:
Dyspnoea is one of the most common symptoms in chronic obstructive pulmonary disease (COPD) and has been associated with poor clinical outcomes.
Aims and objectives:
To investigate relationships between dyspnoea severity, baseline characteristics and outcomes in patients with COPD.
Methods:
Data from two 1-year, randomized trials (NCT00168844; NCT00168831) of tiotropium Respimat® 5 µg and placebo were pooled. This retrospective analysis assessed characteristics and outcomes of patients by Baseline Dyspnea Index score.
Results:
Of 1317 patients, 337 (26%) had mild or no dyspnoea at baseline, 743 (56%) moderate dyspnoea and 237 (18%) severe dyspnoea. Baseline demographic characteristics were similar across dyspnoea categories. However, higher levels of dyspnoea correlated with more advanced COPD (GOLD Stage), and greater use of short-acting bronchodilators and inhaled corticosteroids. Patients with severe dyspnoea reported more exacerbations within the past year. Increasing dyspnoea at baseline correlated with greater risk of moderate-severe (P= 0.0005) and severe (P= 0.0198) exacerbations during the study. Tiotropium reduced moderate-severe exacerbation risk and significantly improved FEV1 and FVC across all dyspnoea categories.
Conclusions:
Patients with more severe dyspnoea had more advanced COPD, and a higher risk of exacerbation. Tiotropium improved outcomes regardless of baseline dyspnoea severity.
Content already presented at ERS congress 2016