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COPD clinical control as a predictor of future exacerbations: concept validation in the SPARK study population
  1. Miriam Barrecheguren1,
  2. Konstantinos Kostikas2,
  3. Karen Mezzi3,
  4. Steven Shen4,
  5. Bernardino Alcazar5,6,
  6. Juan José Soler-Cataluña7,
  7. Marc Miravitlles1,6,
  8. Jadwiga A Wedzicha8
  1. 1 Pneumology Department, Hospital Universitari Vall d’hebron, Barcelona, Spain
  2. 2 Respiratory Medicine Department, University of Ioannina School of Medicine, Ioannina, Greece
  3. 3 Novartis Pharma AG, Basel, Switzerland
  4. 4 Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
  5. 5 Hospital de Alta Resolucion de Loja, Loja, Spain
  6. 6 CIBER de Enfermedades Respiratorias (CIBERES), Spain
  7. 7 Pneumology, Hospital Arnau de Villanova-Lliria, Valencia, Valencia, Spain
  8. 8 National Heart Lung Institute, Airways Disease Section, Imperial College London, London, UK
  1. Correspondence to Dr Marc Miravitlles, Pneumology, Hospital Universitari Vall d'Hebron, Barcelona 08035, Spain; marcm{at}


The concept of chronic obstructive pulmonary disease (COPD) control has been proposed to guide treatment decisions in COPD. In this study, we aimed to validate the prospective value of this concept in the SPARK study population. Control was assessed based on COPD stability and impact. Patients with low impact and stability during weeks 1–12 were classified as controlled, and exacerbations were measured during a 52-week follow-up. Of the 2044 patients included a majority were non-controlled (80%), frequently due to high impact. During the follow-up, the rate of moderate/severe exacerbations was significantly lower in controlled patients (rate ratio, 0.56, 95% CI 0.48 to 0.65 p<0.0001) and time-to-first moderate/severe exacerbation was significantly delayed. This study demonstrated an association between control status and risk of exacerbations.

  • COPD Exacerbations

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  • Contributors MB, KK, KM, BA, JJJJS-C, MM and JAW contributed to study design. KK, KM, SS and JAW were responsible for planning and conducting the study. SS, KK, KM,MM and JAW performed and/or supervised data analysis. MB was responsiblefor drafting the manuscript. All authors contributed to data interpretationand to development of the final manuscript. MM and JAW take responsibilityfor the integrity of the data and the accuracy of the data analysis.

  • Funding This analysis has been funded by Novartis Pharma AG, Basel, Switzerland.

  • Competing interests MB has received speaker fees from Menarini, GlaxoSmithKline, Gebro Pharma, Boehringer Ingelheim, CSL Behring and Grifols and consulting fees from Novartis. KK is an employee and shareholder of Novartis Pharma AG, Basel, Switzerland. KM is an employee of Novartis Pharma AG, Basel, Switzerland. SS is an employee and shareholder of Novartis Pharmaceuticals, New Jersey, USA. BA reports personal fees and grants from Novartis AG, personal fees from Boehringer Ingelheim, personal fees from GSK, personal fees from AstraZeneca, grants and personal fees from Menarini, outside the submitted work. JJJJS-C has received speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Esteve, Ferrer, GSK, Menarini, Novartis, and Pfizer, and consulting fees from AirLiquide, Boehringer Ingelheim, Chiesi, GSK, AstraZeneca, Ferrer and Novartis. MM has received speaker fees from Astra Zeneca, Boehringer Ingelheim, Chiesi, Cipla, Menarini, Rovi, Bial, Grifols and Novartis, consulting fees from Astra Zeneca, Ferrer, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Bial, Gebro Pharma, CSL Behring, Laboratorios Esteve, Mereo Biopharma, Verona Pharma, pH Pharma, Novartis and Grifols and research grants from GlaxoSmithKline and Grifols, outside the submitted work. JAW reports grants from GSK, Johnson and Johnson, Novartis, Boehringer Ingelheim, Astra Zeneca, outside the submitted work.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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