Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598406
Freie Vorträge – Sektion Klinische Pneumologie
Klinische Pneumologie – Jürgen Behr/München, Claus Vogelmeier/Marburg
Georg Thieme Verlag KG Stuttgart · New York

Identification of factors associated with exacerbation risk in severe COPD: multivariate analysis of the WISDOM study

C Vogelmeier
1   Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Gießen and Marburg, Philipps-Universität Marburg
,
LM Fabbri
2   Department of Metabolic Medicine, University of Modena & Reggio Emilia
,
S Bell
3   Department of Biostatistics and Data Sciences, Boehringer Ingelheim
,
K Tetzlaff
4   Boehringer Ingelheim Pharma GmbH & Co. Kg; Department of Sports Medicine, University of Tübingen
,
H Magnussen
5   Pulmonary Research Institute at Lung Clinic Großhansdorf, Airway Research Center North, German Center for Lung Research
,
H Watz
5   Pulmonary Research Institute at Lung Clinic Großhansdorf, Airway Research Center North, German Center for Lung Research
› Author Affiliations
Further Information

Publication History

Publication Date:
23 February 2017 (online)

Also available at
 

Introduction:

Treatment management and patient outcomes could be improved by identifying patients with severe COPD who are at increased risk of exacerbations.

Aim:

To identify factors associated with exacerbation risk using a multivariate analysis of data from the WISDOM study.

Methods:

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.

Results:

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.

Conclusions:

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.

Funding:

Boehringer Ingelheim

Content already presented at ERS congress 2016