Moderate and severe exacerbations have a significant impact on health-related quality of life, utility, and lung function in patients with chronic obstructive pulmonary disease: A meta-analysis.

Exacerbations of chronic obstructive pulmonary disease (COPD) may increase the risk of morbidity and mortality as well as pulmonary complications after surgery among patients with COPD. This meta-analysis was designed to explore the impact of moderate and severe exacerbations of COPD on health-related quality of life (HRQoL), utility, and lung function in patients with COPD. The individual impacts of moderate and severe exacerbations on St George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and EuroQoL-5 dimensions 5 level (EQ-5D-5L) scores, and on forced expiratory volume in 1 s (FEV1) were assessed. Adjustments were applied to account for differences in study design. Outcomes were measured at specific time points across a 12-month study period, for all patients and for subsets with either no or ≥1 severe exacerbations in the year before study entry. The proximity of each measurement in relation to a specific exacerbation was also assessed. A total of seven randomized clinical trials (RCTs) ≥12-month interventional/observational studies with 18,746 COPD patients were assessed. Overall, 4,483 (24%) patients had ≥1 severe exacerbation in the previous year. Moderate and severe exacerbations were associated with worsening from baseline in SGRQ, CAT, EQ-5D-5L, and FEV1 measures; severe exacerbations had greater impact than moderate exacerbations. Moderate and severe exacerbations have a substantial and lasting impact on HRQoL, utility, and lung function in patients with COPD, highlighting a need for effective exacerbation prevention.

Guo J ，Chen Y ，Zhang W ，Tong S ，Dong J ... -  《-》

Exacerbation-related impairment of quality of life and work productivity in severe and very severe chronic obstructive pulmonary disease.

Solem CT ，Sun SX ，Sudharshan L ，Macahilig C ，Katyal M ，Gao X ... -  《International Journal of Chronic Obstructive Pulmonary Disease》

The association of lung function and St. George's respiratory questionnaire with exacerbations in COPD: a systematic literature review and regression analysis.

Martin AL ，Marvel J ，Fahrbach K ，Cadarette SM ，Wilcox TK ，Donohue JF ... -  《-》

Associations between the EQ-5D-5L and exacerbations of chronic obstructive pulmonary disease in the ETHOS trial.

Jackson D ，Jenkins M ，de Nigris E ，Purkayastha D ，Patel M ，Ouwens M ... -  《-》

COPD exacerbations and patient-reported outcomes according to post-bronchodilator FEV(1) - a post-hoc analysis of pooled data.

Management strategies of chronic obstructive pulmonary disease (COPD) need to be tailored to the forced expiratory volume in one second (FEV1), exacerbations, and patient-reported outcomes (PROs) of individual patients. In this study, we analyzed the association and correlation between the FEV1, exacerbations, and PROs of patients with stable COPD. This was a post-hoc analysis of pooled data from two cross-sectional studies that were previously conducted in Malaysia from 2017 to 2019, the results of which had been published separately. The parameters measured included post-bronchodilator FEV1 (PB-FEV1), exacerbations, and scores of modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George's Respiratory Questionnaire for COPD (SGRQ-c). Descriptive, association, and correlation statistics were used. Three hundred seventy-four patients were included in the analysis. The PB-FEV1 predicted was < 30% in 85 (22.7%), 30-49% in 142 (38.0%), 50-79% in 111 (29.7%), and ≥ 80% in 36 (9.6%) patients. Patients with PB-FEV1 < 30% predicted had significantly more COPD exacerbations than those with PB-FEV1 30-49% predicted (p < 0.001), 50-79% predicted (p < 0.001), and ≥ 80% predicted (p = 0.002). The scores of mMRC, CAT, and SGRQ-c were not significantly higher in patients with more severe airflow limitation based on PB-FEV1 (p = 0.121-0.271). The PB-FEV1 predicted had significant weak negative correlations with exacerbations (r = - 0.182, p < 0.001), mMRC (r = - 0.121, p = 0.020), and SGRQ-c scores (r = - 0.114, p = 0.028). There was a moderate positive correlation between COPD exacerbations and scores of mMRC, CAT, and SGRQ-c (r = 0.407-0.482, all p < 0.001). There were significant strong positive correlations between mMRC score with CAT (r = 0.727) and SGRQ-c scores (r = 0.847), and CAT score with SGRQ-c score (r = 0.851) (all p < 0.001). In COPD patients, different severity of airflow limitation was not associated with significant differences in the mMRC, CAT, and SGRQ-c scores. Exacerbations were significantly more frequent in patients with very severe airflow limitation only. The correlation between airflow limitation with exacerbations, mMRC, and SGRQ-c was weak.

Chai CS ，Ng DL ，Bt Mos S ，Ibrahim MAB ，Tan SB ，Pang YK ，Liam CK ... -  《BMC Pulmonary Medicine》