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
› Institutsangaben
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23. Februar 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.


Boehringer Ingelheim

Content already presented at ERS congress 2016