scholarly journals Treatable traits in an English cohort: Prevalence and predictors of future decline in lung function and quality of life in COPD

2021 ◽  
pp. 00934-2020
Author(s):  
Muhammad Rehan Sarwar ◽  
Vanessa Marie McDonald ◽  
Michael John Abramson ◽  
Eldho Paul ◽  
Johnson George
Keyword(s):  
Quality Of Life ◽  
Lung Function ◽  
Precision Medicine ◽  
Airway Disease ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Lifestyle Risk Factors ◽  
The Core

Background“Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease to determine the core traits associated with disease outcomes, where targeted treatments are applied.ObjectivesTo determine the prevalence of TTs in chronic obstructive pulmonary disease (COPD) and which traits predict future decline in lung function and quality of life (QoL).MethodsA 4 year longitudinal evaluation was conducted using data from 3726 participants in the English Longitudinal Study of Ageing (ELSA). TTs were identified based on published recommendations. Traits that predicted decline in lung function and QoL were analysed using generalised estimating equations.ResultsOverall, 21 TTs, including pulmonary (n=5), extra-pulmonary (n=13) and behavioural/lifestyle risk-factors (n=3) were identified. In multivariate analyses, traits of chronic bronchitis (β=−0.186; 95%CI=−0.290 to −0.082), breathlessness (β=−0.093; 95%CI=−0.164 to −0.022), underweight (β=−0.216; 95%CI=−0.373 to −0.058), sarcopaenia (β=−0.162; 95%CI=−0.262 to −0.061), and current smoking (β=−0.228; 95%CI=−0.304 to −0.153), predicted decline in forced expiratory volume in 1 s (FEV1). Of the seven traits that predicted decline in QoL, depression (β=−7.19; 95%CI=−8.81 to −5.57) and poor family and social support (β=−5.12; 95%CI=−6.65 to −3.59) were the strongest.ConclusionThe core TTs of COPD associated with a decline in lung function and QoL were identified. Targeting these impactful traits and individualised treatment using a precision medicine approach may improve outcomes in people with COPD.

Roflumilast Improves Lung Function and Quality of Life in Chronic Obstructive Pulmonary Disease

CHEST Journal ◽  
2004 ◽  
Vol 126 (4) ◽  
pp. 709S ◽  
Author(s):  
Klaus F. Rabe ◽  
D. O’Donnell ◽  
E.D. Bateman ◽  
K. Andrae ◽  
S. Witte ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals The boundaries of mild chronic obstructive pulmonary disease (COPD): design of the searching clinical COPD onset (SOON) study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015731 ◽  
Author(s):  
Gonzalo Labarca ◽  
Andrea Bustamante ◽  
Gonzalo Valdivia ◽  
Rodrigo Díaz ◽  
Álvaro Huete ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airway Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Peripheral Muscle ◽  
Early Grade

IntroductionClinical onset of chronic obstructive pulmonary disease (COPD) is the point at which the disease is first identifiable by physicians. It is a poorly defined stage which seems to include both mild spirometric and non-spirometric disease, and could be described as early grade COPD, for practical purposes. While dyspnoea; chronic bronchitis and CT imaging evidence of emphysema and airway disease may be present very early, the lone significance of dyspnoea, the most relevant symptom in COPD in identifying these individuals, has been scarcely assessed.The Searching Clinical COPD Onset (SOON) Study was designed primarily to detect clinical, physiological and structural differences between dyspnoeic and non-dyspnoeic individuals with early grade COPD. It is hypothesised that presence of dyspnoea in early disease may identify a subtype of individuals with reduced exercise capacity, notwithstanding of their spirometry results. In addition, dyspnoeic individuals will share worse quality of life, lower physical activity, greater lung hyperinflation greater emphysema and airway thickness and reduced peripheral muscle mass than their non-dyspnoeic counterpart.Methods and analysisSOON is a monocentric study, with a cross sectional design aimed at obtaining representative samples of current or ex-smoker-adults aged ≥45 and ≤80 years. Two hundred and forty participants will be enrolled into four strata, according to normal spirometry or mild spirometric obstruction and presence or not of dyspnoea modified Medical Research Council score ≥1. The primary outcome will be the difference between dyspnoeic and non-dyspnoeic individuals on the 6-min walk test performance, regardless of their spirometry results. To account for the confounding effect of heart failure on dyspnoea, stress echocardiography will be also performed. Secondary outcomes will include clinical (quality of life, physical activity), physiological (exercise testing) and structural characteristics (emphysema, airway disease and peripheral muscle mass by CT imaging).Ethics and disseminationThe Institutional Ethics Committee from Pontificia Universidad Católica de Chile has approved the study protocol and signed informed consent will be obtained from all participants. The findings of the trial will be disseminated through relevant peer-reviewed journals and international conference presentations.Trial registration numberNCT03026439.

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