Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients.pdf (512.71 kB)
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Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients.

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journal contribution
posted on 10.04.2017, 08:55 by Philip J. Lawrence, Umme Kolsum, Vandana Gupta, Gavin Donaldson, Richa Singh, Bethan Barker, Leena George, Adam Webb, Anthony J. Brookes, Christopher Brightling, Jawiga Wedzicha, Dave Singh
BACKGROUND: The characteristics and natural history of GOLD B COPD patients are not well described. The clinical characteristics and natural history of GOLD B patients over 1 year in a multicentre cohort of COPD patients in the COPDMAP study were assessed. We aimed to identify the subgroup of patients who progressed to GOLD D (unstable GOLD B patients) and identify characteristics associated with progression. METHODS: Three hundred seventy COPD patients were assessed at baseline and 12 months thereafter. Demographics, lung function, health status, 6 min walk tests and levels of systemic inflammation were assessed. Students t tests and Mann Whitney-U tests were used. RESULTS: One hundred seven (28.9%) of patients were categorised as GOLD B at baseline. These GOLD B patients had similar FEV1 to GOLD A patients (66% predicted). More GOLD B patients were current smokers (p = 0.031), had chronic bronchitis (p = 0.0003) and cardiovascular comorbidities (p = 0.019) compared to GOLD A. At 12 months, 25.3% of GOLD B patients progressed to GOLD D. These patients who progressed (unstable patients) had worse health status and symptoms (SGRQ-C Total, 50.0 v 41.1, p = 0.019 and CAT, 21.0 v 14.0, p = 0.006) and lower FEV1 (60% v 69% p = 0.014) at baseline compared to stable patients who remained in GOLD B. CONCLUSIONS: Unstable GOLD B patients who progressed to GOLD D had a higher level of symptoms at baseline. A high symptom burden may predict an increased likelihood of disease progression in GOLD B patients.

Funding

This study is independent research supported by COPD MAP consortium; Medical Research Council; National Institute for Health Research Respiratory and Allergy Clinical Research Facility at University Hospital of South Manchester NHS Foundation Trust; National Institute for Health Research Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London and NIHR Respiratory Biomedical Research, Leicester.

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Citation

BMC Pulmonary Medicine, 2017, 17 (1), pg. 42

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Infection, Immunity and Inflammation

Version

VoR (Version of Record)

Published in

BMC Pulmonary Medicine

Publisher

BioMed Central

eissn

1471-2466

Acceptance date

11/02/2017

Copyright date

2017

Available date

10/04/2017

Publisher version

https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-017-0384-8#Declarations

Language

en

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