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Reduced COPD Exacerbation Risk Correlates With Improved FEV1: A Meta-Regression Analysis
Alexander D Zider1, Xiaoyan Wang2, Russell G Buhr3
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
Chest
|May 10, 2017
Summary
Improving airway patency, measured by FEV1, is linked to reduced exacerbation risk in COPD patients. This study quantifies the significant correlation between increased FEV1 and fewer COPD exacerbations.
Area of Science:
- Pulmonary Medicine
- Respiratory Research
Background:
- The precise mechanisms by which medications reduce exacerbations in Chronic Obstructive Pulmonary Disease (COPD) are not fully understood.
- This study investigates the role of airway patency improvement in mitigating COPD exacerbation risk.
Purpose of the Study:
- To determine if improved airway patency, assessed by FEV1, correlates with a reduced risk of COPD exacerbations.
- To quantify the relationship between changes in FEV1 and COPD exacerbation rates.
Main Methods:
- A systematic review identified COPD trials reporting changes in pre-dose FEV1 (dFEV1) and moderate-to-severe exacerbations.
- Meta-regression analysis modeled dFEV1 as a moderator for exacerbation rate difference (RD), rate ratio (RR), and hazard ratio (HR).
Main Results:
- Analysis included data from 119,227 patients for RD/RR and 73,475 for HR.
- Every 100-mL increase in dFEV1 was associated with a 21% decrease in HR (P < .001) and a 0.06 decrease in annual exacerbation rate (P = .009).
- This corresponded to a significant RR of 0.86 (P < .001), with findings consistent across subgroup analyses.
Conclusions:
- A significant correlation exists between enhanced FEV1 and diminished COPD exacerbation risk.
- Improved airway patency is suggested as a key mechanism underlying the protective effect of certain medications against COPD exacerbations.
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