Introduction COPD exacerbations cause considerable morbidity and mortality. Early identification and appropriate treatment might improve patient outcomes. We sought to determine whether urinary biomarkers are associated with a COPD exacerbation.

Method Urine samples from paired stable and exacerbation visits from 55 subjects were available from the COPD-BEAT study. 50 biomarkers were analysed in each sample at Mologic (Mologic LTD). Biomarkers that fulfilled the criteria i) a significant parametric pairwise t-test (p≤0.05) and ii) area under the receiver-operator characteristic curve (AUROC ≥0.59) were selected for inclusion in a logistic regression model.

Results The biomarkers that met criteria and were taken forward for further analysis are shown in Table 1. Of these CC16, CRP, MMP8 and NGAL combined had an AUROC 0.82 (95% confidence interval 0.74 to 0.90). The Youden’s index gave a sensitivity and specificity of 78% and 82% respectively.

Conclusion COPD exacerbations can be identified by urinary biomarkers. The biomarker panel requires further validation in a prospective longitudinal study.