Document Detail


Changes in forced expiratory volume in 1 second over time in COPD.
MedLine Citation:
PMID:  21991892     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV(1)), but data on the variability and determinants of this change in patients who have established disease are scarce.
METHODS: We analyzed the changes in FEV(1) after administration of a bronchodilator over a 3-year period in 2163 patients. A random-coefficient model was used to evaluate possible predictors of both FEV(1) levels and their changes over time.
RESULTS: The mean (±SE) rate of change in FEV(1) was a decline of 33±2 ml per year, with significant variation among the patients studied. The between-patient standard deviation for the rate of decline was 59 ml per year. Over the 3-year study period, 38% of patients had an estimated decline in FEV(1) of more than 40 ml per year, 31% had a decline of 21 to 40 ml per year, 23% had a change in FEV(1) that ranged from a decrease of 20 ml per year to an increase of 20 ml per year, and 8% had an increase of more than 20 ml per year. The mean rate of decline in FEV(1) was 21±4 ml per year greater in current smokers than in current nonsmokers, 13±4 ml per year greater in patients with emphysema than in those without emphysema, and 17±4 ml per year greater in patients with bronchodilator reversibility than in those without reversibility.
CONCLUSIONS: The rate of change in FEV(1) among patients with COPD is highly variable, with increased rates of decline among current smokers, patients with bronchodilator reversibility, and patients with emphysema.
Authors:
Jørgen Vestbo; Lisa D Edwards; Paul D Scanlon; Julie C Yates; Alvar Agusti; Per Bakke; Peter M A Calverley; Bartolome Celli; Harvey O Coxson; Courtney Crim; David A Lomas; William MacNee; Bruce E Miller; Edwin K Silverman; Ruth Tal-Singer; Emiel Wouters; Stephen I Rennard;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-09-26
Journal Detail:
Title:  The New England journal of medicine     Volume:  365     ISSN:  1533-4406     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-10-13     Completed Date:  2011-10-19     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1184-92     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00292552
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MeSH Terms
Descriptor/Qualifier:
Aged
Bayes Theorem
Biological Markers / blood*
C-Reactive Protein / analysis
Cytokines / blood
Disease Progression
Female
Follow-Up Studies
Forced Expiratory Volume*
Humans
Male
Middle Aged
Models, Biological
Observation
Pulmonary Disease, Chronic Obstructive / blood,  physiopathology*
Uteroglobin / blood
Grant Support
ID/Acronym/Agency:
G0901697//Medical Research Council; G0901786//Medical Research Council
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cytokines; 0/SCGB1A1 protein, human; 9007-41-4/C-Reactive Protein; 9060-09-7/Uteroglobin
Investigator
Investigator/Affiliation:
H Coxson / ; L Edwards / ; R Tal-Singer / ; D Lomas / ; W MacNee / ; E Silverman / ; C Crim / ; J Vestbo / ; J Yates / ; A Agusti / ; P Calverley / ; B Celli / ; C Crim / ; B Miller / ; W MacNee / ; S Rennard / ; R Tal-Singer / ; E Wouters / ; J Yates / ; Y Ivanov / ; K Kostov / ; J Bourbeau / ; M Fitzgerald / ; P Hernandez / ; K Killian / ; R Levy / ; F Maltais / ; D O'Donnell / ; J Krepelka / ; J Vestbo / ; E Wouters / ; D Quinn / ; P Bakke / ; M Kosnik / ; A Agusti / ; J Sauleda / ; P de Mallorca / ; Y Feschenko / ; V Gavrisyuk / ; L Yashina / ; N Monogarova / ; P Calverley / ; D Lomas / ; W MacNee / ; D Singh / ; J Wedzicha / ; A Anzueto / ; S Braman / ; R Casaburi / ; B Celli / ; G Giessel / ; M Gotfried / ; G Greenwald / ; N Hanania / ; D Mahler / ; B Make / ; S Rennard / ; C Rochester / ; P Scanlon / ; D Schuller / ; F Sciurba / ; A Sharafkhaneh / ; T Siler / ; E Silverman / ; A Wanner / ; R Wise / ; R ZuWallack /
Comments/Corrections
Comment In:
N Engl J Med. 2011 Dec 29;365(26):2540; author reply 2541   [PMID:  22204733 ]
N Engl J Med. 2011 Dec 29;365(26):2540; author reply 2541   [PMID:  22204734 ]
N Engl J Med. 2011 Sep 29;365(13):1246-7   [PMID:  21991899 ]

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