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P141 2-year follow-up of COPD patients in the non-interventional ‘real-life’ daccord study in germany
  1. H Worth1,
  2. R Buhl2,
  3. CP Criée3,
  4. P Kardos4,
  5. C Mailänder5,
  6. N Lossi5,
  7. C Vogelmeier6
  1. 1Facharztforum Fürth, Fürth, Germany
  2. 2Pulmonary Department, Mainz University Hospital, Mainz, Germany
  3. 3Department of Sleep and Respiratory Medicine, Evangelical Hospital Goettingen-Weende, Bovenden, Germany
  4. 4Group Practice and Centre for Allergy, Respiratory and Sleep Medicine, Red Cross Maingau Hospital, Frankfurt, Germany
  5. 5Novartis Pharma GmbH, Nürnberg, Germany
  6. 6Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Centre Giessen and Marburg, Philipps-University Marburg, Member of the German Centre for Lung Research (DZL), Marburg, Germany

Abstract

Introduction Although randomised, controlled trials are important in the development of new pharmacological treatments, they provide limited information on the ‘real life’ management of chronic diseases. Here, we analysed two-year follow-up data from the prospective, non-interventional, observational DACCORD study to evaluate the frequency of exacerbations and the evolution of disease severity using GOLD 2011 categorization.

Methods COPD out-patients were recruited into DACCORD following either a change or initiation of COPD maintenance medication and followed up for 2 years. Data of 3137 patients that completed the 2-year follow-up were analysed; Exacerbation data were collected from the 6 months prior to study entry (baseline), and every 3 months for 2 years after entry; COPD symptoms were evaluated using the COPD Assessment Test (CAT) at baseline as well as the 1 year and 2 year visit.

Results In this cohort the non-exacerbating phenotype was stable with a total of 69.4% of patients without exacerbations in the 6 months prior to baseline not reporting any exacerbation over the full 2 year follow-up period resulting in an annual exacerbation rate of 0.263 in year 1 and 0.251 in year 2. In contrast, patients with at least one exacerbations in the 6 months prior to baseline showed an annual exacerbation rate of 0.770 in year 1 and 0.633 in year 2. At baseline 44.6% of patients were categorised as GOLD D, one third of these due to their exacerbation history alone. In Year 1 there was a general shift to lower risk categories compared to baseline (GOLD D: 44.6% vs. 31.1%) mainly due to a lower number of exacerbations in Year 1. Overall, categorization then remained relatively stable from Year 1 (GOLD D = 31.1%) to Year 2 (GOLD D = 32.1%).

Conclusions Although, COPD is generally considered to be a progressive disease, this analysis of ‘real life’ data over an observational period of 2 years shows that the ‘non-*exacerbating’ phenotype is relatively stable. The data furthermore confirms that exacerbations in the recent history increase the risk of future exacerbations.

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