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Clinical update in COPD
P26 How does the salford lung study in copd (sls copd) patient population fit into the gold 2017 classification grid?
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  1. J Vestbo1,
  2. I Boucot2,
  3. L Frith2,
  4. N Diar Bakerly3,
  5. S Collier2,
  6. DA Leather2,
  7. JM Gibson3,
  8. A Woodcock1
  1. 1Manchester Academic Health Sciences Centre, The University of Manchester, and University Hospital South Manchester NHS Trust, Manchester, UK
  2. 2GSK, Uxbridge, UK
  3. 3Salford Royal NHS Foundation Trust, Salford, UK and Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK

Abstract

Background GOLD 2017 separates spirometric staging from the ‘ABCD’ groupings defined by symptom burden/exacerbation risk. SLS COPD, a 12 month randomised controlled trial, demonstrated the effectiveness and safety of initiating fluticasone furoate/vilanterol versus continuing usual care in COPD patients in UK primary care (Vestbo J et al, New Engl J Med 2016;375:1253–60).

Aim Map SLS COPD patient distribution and treatment patterns to the GOLD 2017 classification grid.

Methods In this post-hoc analysis, patients were classified by GOLD 2017 (groups A–D based on exacerbation frequency history and baseline CAT score) and by the previous spirometry-based GOLD 2007 system (stages 1–4 based on baseline post-BD FEV1).

Results Baseline characteristics were (ITT; n=2799): 49%≥2 moderate/severe exacerbations in past year; 90% CAT score ≥10; 14% on long-acting BD only, 34% ICS ±LABA or LAMA, 52% ICS/LABA+LAMA. The figure shows key data. Distribution by GOLD 2017 was (n=2796): A 7%; B 43%; C 3%; D 47% and by GOLD 2007 (n=2199 with spirometry data): no airflow obstruction 12%; 1 10%; 2 48%; 3 24%; 4 5%. Around 60% of patients had mild/moderate airflow obstruction while 90% were GOLD group B/D due to symptoms and exacerbation risk. GOLD ABCD distribution and treatment patterns in patients without spirometry data were similar to the overall population.

Conclusion These data suggest that COPD exacerbations and symptoms are driving appropriate GP COPD management in routine primary care.

Funding GSK (HZC115151/NCT01551758).

Please refer to page A258 for declarations of interest in relationto abstract P26.

Abstract P26 Figure 1
Abstract P26 Figure 1

SLS COPD patient distribution and baseline treatment by 2017 and 2007 GOLD classification systems.

https://doi.org/10.1136/thoraxjnl-2017-210983.168

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