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Title: Changes in forced expiratory volume in 1 second over time in COPD
Author: Vestbo, Jørgen
Edwards, Lisa D.
Scanlon, Paul D.
Yates, Julie C.
Agustí García-Navarro, Àlvar
Bakke, Per
Calverley, Peter M.
Celli, Bartolome R.
Coxson, Harvey O.
Crim, Courtney
Lomas, David A.
MacNee, William
Miller, Bruce E.
Silverman, Edwin K.
Tal-Singer, Ruth
Wouters, Emiel
Rennard, Stephen I.
Keywords: Malalties pulmonars obstructives cròniques
Assaigs clínics de medicaments
Chronic obstructive pulmonary diseases
Drug testing
Bronchodilator agents
Issue Date: 26-Sep-2011
Publisher: Massachusetts Medical Society
Abstract: Background A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV 1), but data on the variability and determinants of this change in patients who have established disease are scarce. Methods We analyzed the changes in FEV 1 after administration of a bronchodilator over a 3-year period in 2163 patients. A random-coefficient model was used to evaluate possible predictors of both FEV 1 levels and their changes over time. Results The mean (±SE) rate of change in FEV 1 was a decline of 33±2 ml per year, with sig - nificant variation among the patients studied. The between-patient standard deviation for the rate of decline was 59 ml per year. Over the 3-year study period, 38% of patients had an estimated decline in FEV 1 of more than 40 ml per year, 31% had a decline of 21 to 40 ml per year, 23% had a change in FEV 1 that ranged from a de - crease of 20 ml per year to an increase of 20 ml per year, and 8% had an increase of more than 20 ml per year. The mean rate of decline in FEV 1 was 21±4 ml per year greater in current smokers than in current nonsmokers, 13±4 ml per year greater in patients with emphysema than in those without emphysema, and 17±4 ml per year greater in patients with bronchodilator reversibility than in those without reversibility. Conclusions The rate of change in FEV 1 among patients with COPD is highly variable, with increased rates of decline among current smokers, patients with bronchodilator reversibility, and patients with emphysema. (Funded by GlaxoSmithKline; ECLIPSE number, NCT00292552).
Note: Reproducció del document publicat a:
It is part of: New England Journal of Medicine, 2011, vol. 365, num. 13, p. 1184-1192
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ISSN: 0028-4793
Appears in Collections:Articles publicats en revistes (Medicina)

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