TY - JOUR
T1 - Changes in forced expiratory volume in 1 second over time in copd
AU - Vestbo, J.
AU - Edwards, L.D.
AU - Scanlon, P.D.
AU - Yates, J.C.
AU - Agusti, A.
AU - Bakke, P.
AU - Calverley, P.M.
AU - Celli, B.
AU - Coxson, H.O.
AU - Crim, C.
AU - Lomas, D.A.
AU - MacNee, W.
AU - Miller, B.E.
AU - Silverman, E.K.
AU - Tal Singer, R.
AU - Wouters, E.F.M.
AU - Rennard, S.I.
PY - 2011/1/1
Y1 - 2011/1/1
N2 - 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.
AB - 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.
U2 - 10.1056/NEJMoa1105482
DO - 10.1056/NEJMoa1105482
M3 - Article
C2 - 21991892
SN - 0028-4793
VL - 365
SP - 1184
EP - 1192
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 13
ER -