Erin R Camac1, Natalie A Stumpf2, Helen K Voelker3, Gerard J Criner2. 1. College of Medicine, the University of Kentucky, Lexington, Kentucky, United States. 2. Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States. 3. University of Minnesota, Minneapolis, Minnesota, United States.
Abstract
Background: Chronic obstructive pulmonary disease (COPD) patients in the Simvastatin for the Prevention of Exacerbations in Moderate-to-Severe COPD (STATCOPE) and Azithromycin for Prevention of Exacerbations of COPD (MACRO) trials provide an opportunity to prospectively study the short-term effect of acute exacerbations of COPD (AECOPDs). Research Question: We hypothesized that those patients with frequent exacerbations (≥2 AECOPDs per patient year) would experience greater short-term decline in quality of life as measured by the St George's Respiratory Questionnaire (SGRQ). Study Design and Methods: A total of 1934 COPD patients were randomized in STATCOPE or MACRO. Patients who were randomized to azithromycin in MACRO or were followed less than 180 days were excluded. A total of 1219 patients were included. Patients were divided into 2 groups: infrequent exacerbators (< 2 exacerbations per patient year), and frequent exacerbators (≥2 exacerbations per year.) Data were collected at baseline, measured over time, and compared between groups. Results: Of the patients studied, 871 were in the infrequent exacerbators group. A total of 348 were in the frequent exacerbators group. Frequent exacerbators used more respiratory medications, were more likely to have used oxygen, steroids, or antibiotics in the 12 months preceding study entry, had more obstruction on spirometry, and had more severe symptoms as measured by SGRQ at baseline. Over at least 180 days, symptom scores worsened in frequent exacerbators and improved in infrequent exacerbators. Interpretation: Patients with frequent exacerbations of COPD experienced a short-term slight worsening of severely impaired SGRQ symptoms scores, while patients with infrequent exacerbations experienced improvement while on COPD therapies. JCOPDF
Background: Chronic obstructive pulmonary disease (COPD) patients in the Simvastatin for the Prevention of Exacerbations in Moderate-to-Severe COPD (STATCOPE) and Azithromycin for Prevention of Exacerbations of COPD (MACRO) trials provide an opportunity to prospectively study the short-term effect of acute exacerbations of COPD (AECOPDs). Research Question: We hypothesized that those patients with frequent exacerbations (≥2 AECOPDs per patient year) would experience greater short-term decline in quality of life as measured by the St George's Respiratory Questionnaire (SGRQ). Study Design and Methods: A total of 1934 COPD patients were randomized in STATCOPE or MACRO. Patients who were randomized to azithromycin in MACRO or were followed less than 180 days were excluded. A total of 1219 patients were included. Patients were divided into 2 groups: infrequent exacerbators (< 2 exacerbations per patient year), and frequent exacerbators (≥2 exacerbations per year.) Data were collected at baseline, measured over time, and compared between groups. Results: Of the patients studied, 871 were in the infrequent exacerbators group. A total of 348 were in the frequent exacerbators group. Frequent exacerbators used more respiratory medications, were more likely to have used oxygen, steroids, or antibiotics in the 12 months preceding study entry, had more obstruction on spirometry, and had more severe symptoms as measured by SGRQ at baseline. Over at least 180 days, symptom scores worsened in frequent exacerbators and improved in infrequent exacerbators. Interpretation: Patients with frequent exacerbations of COPD experienced a short-term slight worsening of severely impaired SGRQ symptoms scores, while patients with infrequent exacerbations experienced improvement while on COPD therapies. JCOPDF
Authors: T A Seemungal; G C Donaldson; E A Paul; J C Bestall; D J Jeffries; J A Wedzicha Journal: Am J Respir Crit Care Med Date: 1998-05 Impact factor: 21.405
Authors: Fanny W S Ko; Margaret Ip; Paul K S Chan; Joan P C Fok; Michael C H Chan; Jenny C Ngai; Doris P S Chan; David S C Hui Journal: Chest Date: 2007-01 Impact factor: 9.410
Authors: Richard K Albert; John Connett; William C Bailey; Richard Casaburi; J Allen D Cooper; Gerard J Criner; Jeffrey L Curtis; Mark T Dransfield; Meilan K Han; Stephen C Lazarus; Barry Make; Nathaniel Marchetti; Fernando J Martinez; Nancy E Madinger; Charlene McEvoy; Dennis E Niewoehner; Janos Porsasz; Connie S Price; John Reilly; Paul D Scanlon; Frank C Sciurba; Steven M Scharf; George R Washko; Prescott G Woodruff; Nicholas R Anthonisen Journal: N Engl J Med Date: 2011-08-25 Impact factor: 91.245
Authors: François Maltais; Marc Decramer; Richard Casaburi; Esther Barreiro; Yan Burelle; Richard Debigaré; P N Richard Dekhuijzen; Frits Franssen; Ghislaine Gayan-Ramirez; Joaquim Gea; Harry R Gosker; Rik Gosselink; Maurice Hayot; Sabah N A Hussain; Wim Janssens; Micheal I Polkey; Josep Roca; Didier Saey; Annemie M W J Schols; Martijn A Spruit; Michael Steiner; Tanja Taivassalo; Thierry Troosters; Ioannis Vogiatzis; Peter D Wagner Journal: Am J Respir Crit Care Med Date: 2014-05-01 Impact factor: 21.405
Authors: Anne C Melzer; Laura C Feemster; Kristina Crothers; Shannon S Carson; Suzanne E Gillespie; Ashley G Henderson; Jerry A Krishnan; Peter K Lindenauer; Mary Ann McBurnie; Richard A Mularski; Edward T Naureckas; A Simon Pickard; David H Au Journal: Ann Am Thorac Soc Date: 2016-09
Authors: Jorrit B A Welling; Jorine E Hartman; Nick H T Ten Hacken; Karin Klooster; Dirk-Jan Slebos Journal: Eur Respir J Date: 2015-10-22 Impact factor: 16.671
Authors: Margaret K Pasquale; Shawn X Sun; Frank Song; Heather J Hartnett; Stephen A Stemkowski Journal: Int J Chron Obstruct Pulmon Dis Date: 2012-11-01