Assessing COPD profiles and outcomes by dyspnoea severity
23 February 2017 (online)
Dyspnoea is one of the most common symptoms in chronic obstructive pulmonary disease (COPD) and has been associated with poor clinical outcomes.
Aims and objectives:
To investigate relationships between dyspnoea severity, baseline characteristics and outcomes in patients with COPD.
Data from two 1-year, randomized trials (NCT00168844; NCT00168831) of tiotropium Respimat® 5 µg and placebo were pooled. This retrospective analysis assessed characteristics and outcomes of patients by Baseline Dyspnea Index score.
Of 1317 patients, 337 (26%) had mild or no dyspnoea at baseline, 743 (56%) moderate dyspnoea and 237 (18%) severe dyspnoea. Baseline demographic characteristics were similar across dyspnoea categories. However, higher levels of dyspnoea correlated with more advanced COPD (GOLD Stage), and greater use of short-acting bronchodilators and inhaled corticosteroids. Patients with severe dyspnoea reported more exacerbations within the past year. Increasing dyspnoea at baseline correlated with greater risk of moderate-severe (P= 0.0005) and severe (P= 0.0198) exacerbations during the study. Tiotropium reduced moderate-severe exacerbation risk and significantly improved FEV1 and FVC across all dyspnoea categories.
Patients with more severe dyspnoea had more advanced COPD, and a higher risk of exacerbation. Tiotropium improved outcomes regardless of baseline dyspnoea severity.
Content already presented at ERS congress 2016