Identification of factors associated with exacerbation risk in severe COPD: multivariate analysis of the WISDOM study
23 February 2017 (online)
Treatment management and patient outcomes could be improved by identifying patients with severe COPD who are at increased risk of exacerbations.
To identify factors associated with exacerbation risk using a multivariate analysis of data from the WISDOM study.
In WISDOM (NCT00975195; 12-month, randomised, parallel-group study), patients with severe to very severe COPD and a history of exacerbations received 18 µg tiotropium, 100 µg salmeterol and 1000 µg fluticasone propionate daily for 6 weeks, then continued or reduced inhaled corticosteroids (ICS) for 12 weeks. This post hoc multivariate analysis of time to first moderate or severe exacerbation used a stepwise selection process for candidate variables.
For the overall study period, the analysis was based on 2291 patients. Factors associated with a significantly increased risk of exacerbation were taking ICS at screening and ≥2 previous courses of antibiotics or steroids (Figure). Higher baseline FEV1, GOLD C vs. GOLD D and taking xanthines at screening were associated with a significantly decreased risk of exacerbation. A backwards elimination variable selection process confirmed these results.
Several factors were significantly associated with exacerbation risk in WISDOM. An increased risk was found in patients with prior ICS treatment and an exacerbation history.
Content already presented at ERS congress 2016