Chronic Obstructive Pulmonary Diseases:Journal of the COPD Foundation

Volume 4, Issue 2 - 2017

Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation is an open access, peer-reviewed medical/scientific journal dedicated to publishing original research, reviews, and communications related to COPD. Articles are published online as quickly as possible following peer review and editorial acceptance and then aggregated into quarterly issues, and made available to the COPD medical/research community at no charge. The Journal is indexed by PubMed Central.

Editorial:

Remembering John W. Walsh 1949 – 2017

James D. Crapo, MD1,2

Author Affiliations

  1. Editor in Chief, Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
  2. National Jewish Health, Denver, Colorado

Address correspondence to:

James D. Crapo, MD
COPDC@njhealth.org

Abstract

This article does not contain an abstract.

Citation

Citation: Crapo JD. Remembering John Walsh. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 81-82. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0147

Keywords

There are no keywords for this article.

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What’s New with the St George’s Respiratory Questionnaire and Why Do We Care?

Megan Hardin, MD, MPH1 Steven I. Rennard, MD2,3

Author Affiliations

  1. Clinical Discovery Unit, Early Clinical Discovery, AstraZeneca, Waltham, Massachusetts
  2. Clinical Discovery Unit, Early Clinical Discovery, AstraZeneca, Cambridge, United Kingdom
  3. University of Nebraska Medical Center, Omaha

Address correspondence to:

Megan Hardin, MD, MPH
Clinical Discovery Unit
Early Clinical Discovery
AstraZeneca
Waltham, MA
email: megan.hardin@astrazeneca.com

Abstract

This article does not contain an abstract.

Citation

Citation: Hardin M, Rennard SI. What’s new with the St George’s Respiratory Questionnaire and why do we care? Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 83-86. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0139

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Original Research:

Asthma and Chronic Obstructive Pulmonary Disease Overlap: The Effect of Definitions on Measures of Burden

David M. Mannino, MD1 Wen Qi Gan, MD, PhD1 Keele Wurst, PhD, MS2 Kourtney J. Davis, PhD, MS2

Author Affiliations

  1. Department of Preventive Medicine and Environmental Health, College of Public Health, University of Kentucky, Lexington
  2. Real World Evidence and Epidemiology, Research and Development, GlaxoSmithKline Collegeville, Pennsylvania

Address correspondence to:

David M. Mannino, MD
Department of Preventive Medicine and Environmental Health
College of Public Health
University of Kentucky
111 Washington Ave
Lexington, KY 40536
Phone: (859) 218-2099
E-mail: dmannino@uky.edu

Abstract

Background: Although the overlap between asthma and COPD has been recognized for years this overlap has only recently been given a name, asthma-COPD overlap syndrome (ACOS), and better defined. Different definitions of the component diseases can affect prevalence and outcome measures of ACOS.

Methods: We used data from the National Health and Nutrition Examination Survey (NHANES) from 2007-2012 to determine the population estimates of ACOS in U.S. adults using 2 different definitions of ACOS (ACOS1= self-reported COPD and current asthma; ACOS2 = spirometric-confirmed COPD [pre-bronchodilator FEV1/FVC < 70%] and current asthma) and to describe variation in other factors, such as lung function impairment and health care utilization, by ACOS definitions.

Results: Among U.S. adults aged 20 and older, 1.6% had ACOS1, and 1.9% had ACOS2. Both case definitions were similar with regard to symptoms and impairment of lung function. ACOS1 individuals were more likely to have one or more overnight hospital stays relative to those with neither asthma nor COPD, (odds ratio [OR] 3.4, 95% confidence interval [CI] 2.5, 4.6) than ACOS2 (OR 1.6, 95% CI 0.9, 2.9).

Conclusions: Different definitions of ACOS in population-based studies affect both estimates of disease prevalence and outcomes related to the disease. These definitions need to be carefully considered in the design of epidemiologic studies and clinical trials.

Citation

Citation: Mannino DM, Gan WQ, Wurst K, Davis KJ.Asthma and chronic obstructive pulmonary disease overlap: The effect of definitions on measures of burden. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 87-96. doi: http://doi.org/10.15326/jcopdf.4.2.2016.0159

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Subtyping Chronic Obstructive Pulmonary Disease Using Peripheral Blood Proteomics

Sara Zarei, PhD1,2 Ali Mirtar, PhD3 Jarrett D. Morrow, PhD1 Peter J. Castaldi, MD1 Paula Belloni, PhD4 Craig P. Hersh, MD, MPH1

Author Affiliations

  1. Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
  2. San Juan Bautista School of Medicine, Caguas, Puerto Rico
  3. University of California, San Diego
  4. Genentech, San Francisco, California

Address correspondence to:

Craig P. Hersh, MD, MPH
Channing Division of Network Medicine
Brigham and Women’s Hospital
181 Longwood Ave
Boston, MA 02115
Phone: 617-525-0729
Email: craig.hersh@channing.harvard.edu

Abstract

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder. COPD patients may have different clinical features, imaging characteristics and natural history. Multiple studies have investigated heterogeneity using statistical methods such as unsupervised clustering to define different subgroups of COPD based largely on clinical phenotypes. Some studies have performed clustering using genetic data or limited numbers of blood biomarkers. Our primary goal was to use proteomic data to find subtypes of COPD within clinically similar individuals. In the Treatment of Emphysema with a gamma-Selective Retinoid Agonist (TESRA) study, multiplex biomarker panels were run in serum samples collected prior to randomization. After implementing an algorithm to minimize missing values, the dataset included 396 COPD individuals and 87 biomarkers. Using hierarchical clustering, we identified 3 COPD subgroups, containing 267 (67.4%), 104 (26.3%), and 25 (6.3%) individuals, respectively. The third cluster had less emphysema on quantitative analysis of chest computed tomography scans (p=0.03) and worse disease-related quality of life based on the St. George’s Respiratory Questionnaire (total score cluster 1: 45.6, cluster 2: 45.4, cluster 3: 56.6; p=0.01), despite similar levels of lung function impairment (forced expiratory volume in 1 second (49.2%, 49.2%, 48.2 % predicted, respectively). Enrichment analysis showed the biomarkers distinguishing cluster 3 mapped to platelet alpha granule and cell chemotaxis pathways. Thus, we identified a subgroup which has less emphysema but may have greater inflammation, which could be potentially targeted with anti-inflammatory therapies.

Citation

Citation: Zarei S, Mirtar A, Morrow JD, Castaldi PJ, Belloni P, Hersh CP. Subtyping chronic obstructive pulmonary disease using peripheral blood proteomics. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 97-108. doi: http://doi.org/10.15326/jcopdf.4.2.2016.0147

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COPD Biomarker Qualification Consortium:

The COPD Biomarkers Qualification Consortium St George’s Respiratory Questionnaire Manuscripts: Output of a Consortium to Advance Drug Development

Maggie Tabberer, MSc1* Paul W. Jones, PhD, FRCP, FERS1,2*

Author Affiliations

*St Georges’ Respiratory Questionnaire Working Group Chairs for the COPD Biomarkers Qualification Consortium

  1. Research and Development, GlaxoSmithKline, Uxbridge, United Kingdom
  2. Division of Clinical Science, Institute for Infection and Immunity, St George’s University of London, United Kingdom

Address correspondence to:

Paul W. Jones, PhD
St George’s University of London
Email: pjones@sgul.ac.uk
Phone: 44 (0)20 8990 9000

Abstract

This article does not contain an abstract.

Citation

Citation: Tabberer M, Jones PW. The COPD Biomarkers Qualification Consortium St George’s Respiratory Questionnaire manuscripts: Output of a consortium to advance drug development. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 109-111. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0127

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The COPD Biomarkers Qualification Consortium Database: Baseline Characteristics of the St George’s Respiratory Questionnaire Dataset

Maggie Tabberer, MSc1 Victoria S. Benson, PhD1 Heather Gelhorn, PhD2 Hilary Wilson, PhD2 Niklas Karlsson, PhD3 Hana Müllerova, PhD1 Shailendra Menjoge, PhD4 Stephen I. Rennard, MD5,6 Ruth Tal-Singer, PhD7 Debora Merrill, MBA8 Paul W. Jones, PhD, FRCP, FERS1,9 for the COPD Biomarkers Qualification Consortium

Author Affiliations

  1. Research and Development, GlaxoSmithKline, Uxbridge, United Kingdom
  2. Evidera, Bethesda, Maryland
  3. Research and Development, AstraZeneca, Gothenburg, Sweden
  4. Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut
  5. Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha
  6. Research and Development, AstraZeneca, Cambridge, United Kingdom
  7. Research and Development, GlaxoSmithKline, Upper Merion, Pennsylvania
  8. COPD Foundation, Washington, D.C.
  9. Division of Clinical Science, St George’s University of London, United Kingdom

Address correspondence to:

Maggie Tabberer
Research & Development
GlaxoSmithKline
Uxbridge, United Kingdom
Phone:+44 20 8990 2041
Email: margaret.x.tabberer@gsk.com

Abstract

The COPD Biomarkers Qualification Consortium (CBQC) is a public-private partnership formed in 2010 with a goal of qualifying biomarkers and clinical assessment tools for use in clinical or nonclinical decision-making and particularly within the regulatory context.

The St George’s Respiratory Questionnaire (SGRQ) is a measure of health-related quality of life widely used in clinical research. The aim of the CBQC working group on SGRQ was to construct an individual patient level database of clinical trial data that included the SGRQ, to use this to confirm the reliability and validity of the SGRQ as an outcome measure of health status, and investigate its use as a predictor of future events (exacerbations and mortality). This manuscript describes the formulation of the CBQC database and presents the baseline demographic and clinical characteristics of the integrated SGRQ database overall, and by study type (short-term [≤1 year], medium-term [2-4 years] and observational studies).

Distribution of baseline SGRQ scores varied little by demographic determinants except for income region in the observational data set (low-middle income countries +10 units compared with high income, p<0.0001) and this observation held across studies. SGRQ scores increased with increasing modified Medical Research Council dyspnea scores (mean differences ranged 6.9-17.9 units) and with increasing airflow limitations (Global initiative for chronic Obstructive Lung Disease grades 1 to 4; differences ranged 4.5-16.1 units), consistent across study types.

As a method of cross-sectional comparison, the SGRQ appears to be relatively free of bias from demographic factors although care should be taken when making cross sectional comparisons of scores between patients in countries at different levels of socio-economic development/

Citation

Citation: Tabberer M, Benson VS, Gelhorn H, et al. The COPD Biomarkers Qualification Consortium database: Baseline characteristics of the St George’s Respiratory Questionnaire dataset. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 112-123. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0128

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Responder Analyses for Treatment Effects in COPD Using the St George’s Respiratory Questionnaire

Paul W. Jones, PhD, FRCP, FERS1,2 Heather Gelhorn, PhD3 Hilary Wilson, PhD3 Niklas Karlsson, PhD4 Shailendra Menjoge, PhD5 Hana Müllerova, PhD2 Stephen I. Rennard, MD6,7 Ruth Tal-Singer, PhD8 Debora Merrill, MBA9 Maggie Tabberer, MSc2

Author Affiliations

  1. Division of Clinical Science and Institute of Infection and Immunity, St George’s University of London, United Kingdom
  2. Research and Development, GlaxoSmithKline, Uxbridge, United Kingdom
  3. Evidera, Bethesda, Maryland
  4. Research and Development, AstraZeneca, Gothenburg, Sweden
  5. Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut
  6. Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha
  7. Research and Development, AstraZeneca, Cambridge, United Kingdom
  8. Research and Development, GlaxoSmithKline, Upper Merion, Pennsylvania
  9. COPD Foundation, Washington, D.C.

Address correspondence to:

Paul W. Jones, PhD, FRCP, FERS
St George’s University of London
London, United Kingdom
Email: pjones@sgul.ac.uk.
Phone: +44 (0)20 8990 9000

Abstract

Background: Patient-reported outcomes data in clinical trials are usually reported as mean values, interpreted in comparison to a minimum clinically important difference (MCID) and ignoring the possibility of a sizable proportion of patients experiencing a worthwhile benefit when the majority did not. This analysis tested the reliability of calculated responder rates (from chronic obstructive pulmonary disease [COPD] patients) with the St George’s Respiratory Questionnaire (SGRQ) using a range of responder cut-points above and below the MCID (4 units).

Methods: Individual patient data (i.e., data from long-acting bronchodilator [LAB] and inhaled corticosteroids [ICS]/long-acting beta2-agonist [LABA] randomized clinical studies) in the COPD Biomarker Qualification Consortium database were used: short-term (≤1-year duration; 14,814 patients,) and medium-term (2-4 years; 12,043 patients). Responder rates versus placebo across SGRQ score change thresholds ranging from -1.5 to -8.0 were tested; differences were expressed as the odds ratio (OR) of a patient exceeding the threshold versus no change or deterioration.

Results: The ORs measuring benefit of active treatment were similar across thresholds in short-term studies (LAB, ORs 1.40-1.42; LABA/ICS, 1.50-1.56) and medium-term LAB studies (ORs 1.34-1.43), whereas ORs in medium-term studies with LABA/ICS intervention showed a trend for higher response rates at higher values of threshold cut-points (1.64-1.79). In short-term studies, different thresholds had little effect on the OR between active drugs versus a trend for lower ORs with lower thresholds in medium-term studies.

Conclusions: The OR for a treatment effect compared with placebo appears consistent across a range of responder cut-points. In medium-term trials, the treatment difference between active drugs suggests that use of a lower threshold would not increase the odds of observing a measured treatment difference.

Citation

Citation: Jones PW, Gelhorn H, Wilson H, et al. Responder analyses for treatment effects in COPD using the St George’s Respiratory Questionnaire. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 124-131. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0130

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Baseline Severity as Predictor of Change in St George’s Respiratory Questionnaire Scores in Trials of Long-acting Bronchodilators with COPD Patients

Paul W. Jones, PhD, FRCP, FERS1,2 Heather Gelhorn, PhD3 Niklas Karlsson, PhD4 Shailendra Menjoge, PhD5 Hana Müllerova, PhD2 Stephen I. Rennard, MD6,7 Ruth Tal-Singer, PhD8 Hilary Wilson, PhD3 Debora Merrill, MBA9 Maggie Tabberer, MSc2

Author Affiliations

  1. Institute of Infection and Immunity, St George’s University of London, United Kingdom
  2. Research and Development, GlaxoSmithKline, Uxbridge, United Kingdom
  3. Evidera, Bethesda, Maryland
  4. Research and Development, AstraZeneca, Gothenburg, Sweden
  5. Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut
  6. Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha
  7. Research and Development, AstraZeneca, Cambridge, United Kingdom
  8. Research and Development, GlaxoSmithKline, King of Prussia, Pennsylvania
  9. COPD Foundation, Washington, D.C.

Address correspondence to:

Paul W. Jones, PhD, FRCP, FERS
Institute of Infection and Immunity
St George’s University of London
London, United Kingdom
Email: pjones@sgul.ac.uk
Phone: +44 (0)20 8990 9000

Abstract

Background: In trials oflong-acting bronchodilators, health status is an important trial outcome, however the influence of baseline severity on response measured by St George’s Respiratory Questionnaire (SGRQ) is not known. We have compared SGRQ changes between patients with chronic obstructive pulmonary disease (COPD) of mild-moderate severity or dyspnea (Global initiative for chronic Obstructive Lung disease [GOLD] grades 1 and 2; modified Medical Research Council [mMRC] grades 1 and 2) to those with severe-very severe severity or dyspnea (GOLD grades 3 and 4; mMRC grades 3 and 4).

Methods: Combined individual patient data from the COPD Biomarkers Qualification Consortium database (trials of long-acting bronchodilators) were used comprising of patients from short-term (≤1-year duration; n=10802) and medium-term (2-4 years’ duration; n=8963) studies. A repeated measures analysis of variance (ANOVA) was used to determine the effects of baseline severity (GOLD/mMRC) on SGRQ response to treatment. All treatment arms were combined.

Results: In short-term studies, milder patients showed a greater response than those with more severe disease in terms of GOLD grade (partial Eta2 = 0.03, p < 0.0001) and mMRC grade (partial Eta2 = 0.05, p < 0.0001). Similar results were seen in the medium-term studies (partial Eta2 = 0.02, p < 0.0001; mMRC: partial Eta2 = 0.05, p < 0.0001,).

Conclusions: Patients with less severe airflow limitation and less severe dyspnea showed larger improvements in SGRQ score than more severely obstructed or dyspneic patients. Although these severity influences are small (2%-5% of the variance in SGRQ score), they do suggest that pre-specified separate analyses are warranted to test for differences in response, based on baseline severity.

Citation

Citation: Jones PW, Gelhorn H, Karlsson N, et al. Baseline severity as predictor of change in St George’s Respiratory Questionnaire scores in trials of long-acting bronchodilators with COPD patients. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 132-140. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0129

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St George’s Respiratory Questionnaire Score Predicts Outcomes in Patients with COPD: Analysis of Individual Patient Data in the COPD Biomarkers Qualification Consortium Database

Hana Müllerova, PhD1 Heather Gelhorn, PhD2 Hilary Wilson, PhD2 Victoria S. Benson, PhD1 Niklas Karlsson, PhD3 Shailendra Menjoge, PhD4 Stephen I. Rennard, PhD5,6 Maggie Tabberer, MSc1 Ruth Tal-Singer, PhD7 Debora Merrill, MBA8 Paul W. Jones, PhD, FRCP, FERS1,9

Author Affiliations

  1. Research and Development, GlaxoSmithKline, Uxbridge, United Kingdom
  2. Evidera, Bethesda, Maryland
  3. Research and Development, AstraZeneca, Mölndal, Sweden
  4. Boehringer-Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut
  5. Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha
  6. AstraZeneca, Cambridge, United Kingdom
  7. Respiratory Therapy Area Unit, Research and Development, GlaxoSmithKline, King of Prussia, Pennsylvania
  8. COPD Foundation, Washington, D.C.
  9. Institute for Infection and Immunity, St George’s University of London, United Kingdom

Address correspondence to:

Hana Müllerová, PhD
Respiratory Epidemiology
Research and Development
GlaxoSmithKline
Stockley Park West
1-3 Ironbridge Road
Uxbridge, Middlesex, UB11 1BT
United Kingdom
Email: hana.x.muellerova@gsk.com

Abstract

Background: We aimed to estimate the usefulness of a disease specific health status measure, the St George’s Respiratory Questionnaire (SGRQ), to predict outcomes in patients with chronic obstructive pulmonary disease (COPD).

Methods: Individual patient-data of 12043 patients from long-term randomized clinical trials (2-4 years’ duration) in the COPD Biomarkers Qualification Consortium database were analyzed. The adverse COPD outcomes were: exacerbations of COPD, hospital admissions due to exacerbation and all-cause mortality. Cox proportional hazards regression was used to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CIs) for quartiles of SGRQ scores at baseline and time to first event, and time from first to second event, where appropriate.

Results: The risk of adverse COPD outcomes increased with each increasing quartile of SGRQ score for all time to first event analyses. When comparing the lowest versus the highest quartile, the event risk (HRs [95% CIs]) increased by 40% for exacerbations (1.40 [1.29, 1.51]); 2-fold for hospital admissions (2.01 [1.78, 2.28]) and more than 2-fold for all-cause mortality (2.30 [1.91, 2.78]). For second event analyses in a subset of eligible patients, these trends persisted albeit with reduced risk estimates for exacerbations.

Conclusions: Among patients with COPD, health status measured by a SGRQ score predicted exacerbations of COPD, hospital admissions due to exacerbations and their recurrence and death after adjustment. These data support the rationale for a health status measure use as a drug development tool and suggest that a health status measure may also have a role in risk assessment for COPD patients in routine medical care.

Citation

Citation: Müllerova H, Gelhorn H, Wilson H, et al.St George’s Respiratory Questionnaire score predicts outcomes in patients with COPD: Analysis of individual patient data in the COPD Biomarkers Qualification Consortium Database. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 141-149. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0131

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Socioeconomic Status as a Determinant of Health Status Treatment Response in COPD Trials

Paul W. Jones, PhD, FRCP, FERS1 Heather Gelhorn, PhD2 Hilary Wilson, PhD2 Victoria S. Benson, PhD3 Niklas Karlsson, PhD4 Shailendra Menjoge, PhD5 Hana Müllerova, PhD3 Stephen I. Rennard, MD6 Ruth Tal-Singer, PhD7 Debora Merrill, MBA8 Maggie Tabberer, MSc3

Author Affiliations

Paul W. Jones, PhD, FRCP, FERS
Institute for Infection and Immunity
St George’s University of London
London, United Kingdom
Email: pjones@sgul.ac.uk.
Phone: +44 (0)20 8990 9000

Address correspondence to:

  1. Institute for Infection and Immunity, St George’s University of London, United Kingdom
  2. Evidera, Bethesda, Maryland
  3. Research and Development, GlaxoSmithKline, Uxbridge, United Kingdom
  4. Research and Development, AstraZeneca, Gothenburg, Sweden
  5. Boehringer-Ingelheim Pharmaceuticals, Inc., Ridgefield, Connecticut
  6. Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha
  7. Research and Development, GlaxoSmithKline, King of Prussia, Pennsylvania
  8. COPD Foundation, Washington, D.C.

Abstract

Background: Randomized controlled trials (RCTs) often recruit patients from low and high socioeconomic status (SES) countries, but little is known about the effect of SES on clinical outcomes, particularly patient-centered measures of symptomatic benefit.

Methods: Combined individual chronic obstructive pulmonary disease (COPD) patient data from the placebo and long-acting bronchodilator arms of 17 RCTs (from the COPD Biomarkers Qualification Consortium database) were analyzed. Health status was measured using the St George’s Respiratory Questionnaire (SGRQ) (minimum clinically important difference [MCID]: 4 units). Trials were grouped into short-term (≤12 months) and medium-term (>12 months to 48 months). A participant’s country of residence was categorized into Low/Medium or High SES using World Health Organization criteria.

Results: Data from 19765 individuals (6109 Low/Medium SES) were available. Patients in Low/Medium SES countries had more severe disease at baseline. Improvement in SGRQ score with placebo was ≈2 units greater in Low/Medium than in High SES countries; at its greatest, the improvement from baseline exceeded the MCID in Low/Medium countries. This difference was maintained for at least 1 year. Improvement with bronchodilator was also greater in Low/Medium versus High SES countries; overall there was no evidence that the treatment effect versus placebo was different between countries of different SES status.

Conclusions: Participants in Low/Medium SES countries experienced significantly larger treatment effects, irrespective of treatment group (placebo and bronchodilator). Despite this, COPD patients in Low/Medium SES countries experienced a health status gain from long-acting bronchodilator treatment that is similar to that seen in High SES countries.

Citation

Citation: Jones PW, Gelhorn H, Wilson H, et al. Socioeconomic status as a determinant of health status treatment response in COPD trials. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 150-158. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0132

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The COPD Pipeline:

The COPD Pipeline XXXIV

Nicholas J. Gross MD, PhD1

Author Affiliations

  1. University Medical Research, Saint Francis Hospital and Medical Center, Hartford, Connecticut

Address correspondence to:

Nicholas Gross, MD, PhD
grossnicholas1@gmail.com

Abstract

This article does not contain an abstract.

Citation

Citation: Gross N. The COPD pipeline XXXIV. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 159-161. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0138

Keywords

There are no keywords for this article.

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Journal Club:

Journal Club: Inhaled Corticosteroids– Refining Our Understanding of Their Role in Maintenance Treatment for COPD

Ron Balkissoon, MD, MSc, DIH, FRCPC1

Author Affiliations

  1. Denver, Colorado

Address correspondence to:

Ron Balkissoon, MD, MSc, DIH, FRCPC
balkissoonr@njhealth.org

Abstract

This article does not contain an abstract.

Citation

Citation: Balkissoon R. Journal club: Inhaled corticosteroids—refining our understanding of their role in maintenance treatment for COPD. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 162-167. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0143

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Images In COPD:

Images in COPD: Bullous Emphysema with Mycetoma

Simukayi Mutasa, MD1

Author Affiliations

  1. New York Presbyterian Hospital, Columbia University Medical Center, New York, New York

Address correspondence to:

Simukayi Mutasa, MD
New York Presbyterian Hospital
PB 1-301
New York, NY 10032
Email: stm9116@nyp.org

Abstract

This article does not contain an abstract.

Citation

Citation: Mutasa S. Images in COPD: Bullous emphysema with mycetoma. Chronic Obstr Pulm Dis (Miami). 2017; 4(2): 168-171. doi: http://doi.org/10.15326/jcopdf.4.2.2017.0144

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