Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients.pdf (512.71 kB)
Characteristics and longitudinal progression of chronic obstructive pulmonary disease in GOLD B patients.
journal contributionposted on 2017-04-10, 08:55 authored by Philip J. Lawrence, Umme Kolsum, Vandana Gupta, Gavin Donaldson, Richa Singh, Bethan Barker, Leena George, Adam Webb, Anthony J. Brookes, Christopher Brightling, Jawiga Wedzicha, Dave Singh
BACKGROUND: The characteristics and natural history of GOLD B COPD patients are not well described. The clinical characteristics and natural history of GOLD B patients over 1 year in a multicentre cohort of COPD patients in the COPDMAP study were assessed. We aimed to identify the subgroup of patients who progressed to GOLD D (unstable GOLD B patients) and identify characteristics associated with progression. METHODS: Three hundred seventy COPD patients were assessed at baseline and 12 months thereafter. Demographics, lung function, health status, 6 min walk tests and levels of systemic inflammation were assessed. Students t tests and Mann Whitney-U tests were used. RESULTS: One hundred seven (28.9%) of patients were categorised as GOLD B at baseline. These GOLD B patients had similar FEV1 to GOLD A patients (66% predicted). More GOLD B patients were current smokers (p = 0.031), had chronic bronchitis (p = 0.0003) and cardiovascular comorbidities (p = 0.019) compared to GOLD A. At 12 months, 25.3% of GOLD B patients progressed to GOLD D. These patients who progressed (unstable patients) had worse health status and symptoms (SGRQ-C Total, 50.0 v 41.1, p = 0.019 and CAT, 21.0 v 14.0, p = 0.006) and lower FEV1 (60% v 69% p = 0.014) at baseline compared to stable patients who remained in GOLD B. CONCLUSIONS: Unstable GOLD B patients who progressed to GOLD D had a higher level of symptoms at baseline. A high symptom burden may predict an increased likelihood of disease progression in GOLD B patients.
This study is independent research supported by COPD MAP consortium; Medical Research Council; National Institute for Health Research Respiratory and Allergy Clinical Research Facility at University Hospital of South Manchester NHS Foundation Trust; National Institute for Health Research Respiratory Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London and NIHR Respiratory Biomedical Research, Leicester.
CitationBMC Pulmonary Medicine, 2017, 17 (1), pg. 42
Author affiliation/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Infection, Immunity and Inflammation
- VoR (Version of Record)