- Article
- Source: Campus Sanofi
- May 15, 2024
The Impact of Exacerbations in COPD
COPD Exacerbation risk has been shown to accelerate after each exacerbation.2,a
Exacerbation risk accelerates after each exacerbation1
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*Severe exacerbations were defined as those which resulted in hospitalization with a primary discharge diagnosis of COPD2
Despite triple inhaled therapyc, the current standard of care, many patients remain symptomatic as defined by persistent symptoms and exacerbations.
Listen to Prof Nicola Hanania: “Prevention of exacerbations is the key goal”
2:07 minutes
Nicola Hanania is Professor of Medicine, Section Chief of Pulmonary Critical Care and Sleep Medicine at the Ben Taub Hospital in Houston, Texas, and Director of the Airways Clinical Research Center, ACRC, at the Bear College of Medicine.
Listen to the whole episode of the podcast on the EMJ website
Sponsored by Sanofi and Regeneron, in partnership with EMJ.
COPD unfortunately is a chronic disease as the name implies. So, it’s a progressive disease. While we cannot cure it, we can manage it, we can treat it. Unfortunately, there are several events in the course of the disease that makes it worse, not only for the patient but for the healthcare system: it increases risk of hospitalization, mortality… And one of them is exacerbations. I call it “lung attacks”. Pretty much what happens with exacerbations is these patients who have daily symptoms become having more symptoms, they may have more cough, increasing sputum production, sometimes these exacerbations are driven by infections – most of the time actually – and they end up needing more and more treatments including antibiotics, steroids. And sometimes unfortunately may end up pushing the patient to go to emergency department or getting hospitalized. Unfortunately, exacerbations is not just the fact that they occur and we can treat them, it’s every time the patient gets an exacerbation it puts his or her lung function down. In fact, there has been good data now to show that repeated exacerbations can contribute to increase risk of worsening exacerbations subsequently, but worsening lung function over long time, and they don’t recuperate lung function, so, meaning every time they get an exacerbation it puts them down both the lung function and the quality of life. There is definitely good data to show that repeated exacerbations have been linked to increased mortality and so on. So that’s why one of the major goals in managing this disease is try to prevent these lung attacks from occurring. Prevention of exacerbations is the key goal in managing this disease. Naturally exacerbations tend to be more frequent in those patients with more severe disease. But they can occur even in moderate COPD as well, in some situations.
COPD Exacerbations may lead to accelerated lung function decline3,e
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Loss of lung function nearly doubled3
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Irreversible lung function decline may occur after only one COPD exacerbation3
aBased on data from a large population-based cohort of 73,106 Canadian patients (mean age 75 years) who were hospitalized for the first time because of a severe exacerbation of COPD (1990-2005, followed until death or March 31, 2007).2
bAdjusted for age, sex, calendar time, and the modified Chronic Disease Score.2
cOr double inhaled therapy if ICS is contraindicated.15
d52-week, randomized, double-blind, phase 3 trial that assessed the efficacy and safety of fluticasone furoate/umeclidinium/vilanterol triple therapy versus fluticasone furoate/vilanterol or umeclidinium/vilanterol in patients aged ≥40 years with symptomatic COPD and a history of exacerbations.2
eFEV1 decline after a single moderate-to-severe exacerbation. Based on a retrospective analysis of data from 586 patients with moderate-to-severe COPD.5
aHR, adjusted hazard ratio; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; QoL, quality of life
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