Study Questions Trends in COPD Exacerbation Frequency

The majority of patients with chronic obstructive pulmonary disease (COPD) in the general population experience changes in COPD exacerbation frequency over time, according to the findings of a new study.

The researchers conducted a nationwide register-based descriptive study of patients with at least 1 COPD exacerbation in 2003 in Denmark. During the 10-year follow-up, researchers categorized patients as frequent, infrequent, and non-exacerbators, and quantified the flow between categories.
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A total of 19,752 patients with COPD who experienced at least 1 exacerbation in 2003 were identified, and 30% were classified as frequent exacerbators.

During follow-up, the majority of exacerbators in 2003 were identified as non-exacerbators in the following years, with non-exacerbators increasing from 60% in 2004 to 68% in 2012.

Approximately half of frequent exacerbators experienced a decrease in exacerbation frequency within a year and experienced either 1 or no exacerbations in the following year. The researchers found this pattern to be stable throughout the 10-year follow-up.

Within a 5-year follow-up period, only 6% of frequent exacerbators in 2003 remained in this category. 

“In conclusion, this real-life study found considerable variations in the exacerbation rate over time and indicates that the majority of COPD patients in the general population do not persist with frequent exacerbations as a stable feature of their disease,” the researchers concluded. “This might hold implications for chronic obstructive pulmonary disease treatment guidelines and their practical application.”

—Melissa Weiss

Reference:

Reilev M, Lykkegaard J, Halling A, Vestbo J, Søndergaard J, and Pottegård A. Stability of the frequent COPD exacerbator in the general population: a Danish nationwide register-based study [published online April 17, 2017]. NPJ Prim Care Respir Med. doi:10.1038/s41533-017-0029-7.