Changes in forced expiratory volume in 1 second over time in COPD

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

Research output: Contribution to journalArticle

595 Scopus citations

Abstract

BACKGROUND: A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV1), but data on the variability and determinants of this change in patients who have established disease are scarce. METHODS: We analyzed the changes in FEV1 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 FEV1 levels and their changes over time. RESULTS: The mean (±SE) rate of change in FEV1 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 FEV1 of more than 40 ml per year, 31% had a decline of 21 to 40 ml per year, 23% had a change in FEV1 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 FEV1 among patients with COPD is highly variable, with increased rates of decline among current smokers, patients with bronchodilator reversibility, and patients with emphysema. (Funded by GlaxoSmithKline; ECLIPSE ClinicalTrials.gov number, NCT00292552.)

Original languageEnglish (US)
Pages (from-to)1184-1192
Number of pages9
JournalNew England Journal of Medicine
Volume365
Issue number13
DOIs
StatePublished - Sep 29 2011

ASJC Scopus subject areas

  • Medicine(all)

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