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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 Broncodilatadors 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 ClinicalTrials.gov number, NCT00292552). |
Note: | Reproducció del document publicat a: http://dx.doi.org/10.1056/NEJMoa1105482 |
It is part of: | New England Journal of Medicine, 2011, vol. 365, num. 13, p. 1184-1192 |
URI: | http://hdl.handle.net/2445/47024 |
Related resource: | http://dx.doi.org/10.1056/NEJMoa1105482 |
ISSN: | 0028-4793 |
Appears in Collections: | Articles publicats en revistes (Medicina) |
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