TY - JOUR
T1 - Characteristics, stability and outcomes of the 2011 GOLD COPD groups in the ECLIPSE cohort
AU - Agusti, Alvar
AU - Edwards, Lisa D.
AU - Celli, Bartolomé
AU - MacNee, William
AU - Calverley, Peter M.A.
AU - Müllerova, Hana
AU - Lomas, David A.
AU - Wouters, Emiel
AU - Bakke, Per
AU - Rennard, Steve
AU - Crim, Courtney
AU - Miller, Bruce E.
AU - Coxson, Harvey O.
AU - Yates, Julie C.
AU - Tal-Singer, Ruth
AU - Vestbo, Jørgen
PY - 2013/9/1
Y1 - 2013/9/1
N2 - The 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifies patients with chronic obstructive pulmonary disease (COPD) into four groups (A to D). We explored the characteristics, stability and relationship to outcomes of these groups within the ECLIPSE study (Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points) (n52101). Main results showed that: 1) these groups differed in several clinical, functional, imaging and biological characteristics in addition to those used for their own definition; 2) A and D groups were relatively stable over time, whereas groups B and C showed more temporal variability; 3) the risk of exacerbation over 3 years increased progressively from A to D, whereas that of hospitalisation and mortality were lowest in A, highest in D and intermediate and similar in B and C, despite the former having milder airflow limitation. The prevalence of comorbidities and persistent systemic inflammation were highest in group B. The different longitudinal behaviour of group A versus B and C versus D (each pair with similar forced expiratory volume in1 s (FEV1) values supports the 2011 GOLD proposal of assessing COPD patients by more than FEV1 only. However the assumption that symptoms do not equate to risk appears to be naïve, as groups B and C carry equally poor clinical outcomes, though for different reasons.
AB - The 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifies patients with chronic obstructive pulmonary disease (COPD) into four groups (A to D). We explored the characteristics, stability and relationship to outcomes of these groups within the ECLIPSE study (Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points) (n52101). Main results showed that: 1) these groups differed in several clinical, functional, imaging and biological characteristics in addition to those used for their own definition; 2) A and D groups were relatively stable over time, whereas groups B and C showed more temporal variability; 3) the risk of exacerbation over 3 years increased progressively from A to D, whereas that of hospitalisation and mortality were lowest in A, highest in D and intermediate and similar in B and C, despite the former having milder airflow limitation. The prevalence of comorbidities and persistent systemic inflammation were highest in group B. The different longitudinal behaviour of group A versus B and C versus D (each pair with similar forced expiratory volume in1 s (FEV1) values supports the 2011 GOLD proposal of assessing COPD patients by more than FEV1 only. However the assumption that symptoms do not equate to risk appears to be naïve, as groups B and C carry equally poor clinical outcomes, though for different reasons.
UR - http://www.scopus.com/inward/record.url?scp=84879735745&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84879735745&partnerID=8YFLogxK
U2 - 10.1183/09031936.00195212
DO - 10.1183/09031936.00195212
M3 - Article
C2 - 23766334
AN - SCOPUS:84879735745
SN - 0903-1936
VL - 42
SP - 636
EP - 646
JO - European Respiratory Journal
JF - European Respiratory Journal
IS - 3
ER -