Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort
The association between exacerbation aetiology and exacerbation frequency is poorly understood. We analysed 2-year follow-up data from a prospective observational study of patients with chronic obstructive pulmonary disease (COPD) (www.clinicaltrials.gov identifier number NCT01360398) to evaluate ye...
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2019-02-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/5/1/00248-2018.full |
| _version_ | 1828372723079839744 |
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| author | Tom M.A. Wilkinson Emmanuel Aris Simon C. Bourne Stuart C. Clarke Mathieu Peeters Thierry G. Pascal Laura Taddei Andrew C. Tuck Viktoriya L. Kim Kristoffer K. Ostridge Karl J. Staples Nicholas P. Williams Anthony P. Williams Stephen A. Wootton Jeanne-Marie Devaster The AERIS Study Group: J. Alnajar R. Anderson E. Aris W.R. Ballou A. Barton S. Bourne M. Caubet S.C. Clarke D. Cleary C. Cohet N.A. Coombs K. Cox J-M. Devaster V. Devine N. Devos E. Dineen T. Elliott R. Gladstone S. Harden J. Jefferies V.L. Kim P. Moris K.K. Ostridge T.G. Pascal M. Peeters B. Sente S. Schoonbroodt K.J. Staples A.C. Tuck L. Welch V. Weynants T.M.A. Wilkinson A.P. Williams N.P. Williams C. Woelk M. Wojtas S.A. Wootton |
| author_facet | Tom M.A. Wilkinson Emmanuel Aris Simon C. Bourne Stuart C. Clarke Mathieu Peeters Thierry G. Pascal Laura Taddei Andrew C. Tuck Viktoriya L. Kim Kristoffer K. Ostridge Karl J. Staples Nicholas P. Williams Anthony P. Williams Stephen A. Wootton Jeanne-Marie Devaster The AERIS Study Group: J. Alnajar R. Anderson E. Aris W.R. Ballou A. Barton S. Bourne M. Caubet S.C. Clarke D. Cleary C. Cohet N.A. Coombs K. Cox J-M. Devaster V. Devine N. Devos E. Dineen T. Elliott R. Gladstone S. Harden J. Jefferies V.L. Kim P. Moris K.K. Ostridge T.G. Pascal M. Peeters B. Sente S. Schoonbroodt K.J. Staples A.C. Tuck L. Welch V. Weynants T.M.A. Wilkinson A.P. Williams N.P. Williams C. Woelk M. Wojtas S.A. Wootton |
| author_sort | Tom M.A. Wilkinson |
| collection | DOAJ |
| description | The association between exacerbation aetiology and exacerbation frequency is poorly understood. We analysed 2-year follow-up data from a prospective observational study of patients with chronic obstructive pulmonary disease (COPD) (www.clinicaltrials.gov identifier number NCT01360398) to evaluate year-to-year variation in exacerbation frequency and related aetiology. A total of 127 patients underwent blood and sputum sampling monthly and at exacerbation to detect respiratory infections and eosinophilic inflammation; 103 continued into year 2 and 88 completed both years. The most common bacterial species at stable state and exacerbation was Haemophilus influenzae. Among infrequent exacerbators (one exacerbation per year), the incidence of viral infection at exacerbation was high (60.0% (95% CI 35.1–81.7%) in year 1 and 78.6% (53.4–94.2%) in year 2). Those with more frequent exacerbations tended to have higher relative incidence of bacterial than viral infection. Patients with at least two additional exacerbations in year 2 versus year 1 had a higher risk of H. influenzae colonisation at stable state than those with at least two fewer exacerbations, as detected by culture (OR 1.43 (95% CI 0.71–2.91) versus 0.63 (0.40–1.01), p=0.06) and PCR (1.76 (95% CI 0.88–3.51) versus 0.56 (0.37–0.86), p<0.01). This was not seen with other infection types or eosinophilic inflammation. Analysis of the same cohort over 2 years showed, for the first time, that changes in yearly COPD exacerbation rate may be associated with variations in H. influenzae colonisation. |
| first_indexed | 2024-04-14T07:08:06Z |
| format | Article |
| id | doaj.art-540ca4bc52544e00b32d12c320a830b0 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-04-14T07:08:06Z |
| publishDate | 2019-02-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-540ca4bc52544e00b32d12c320a830b02022-12-22T02:06:30ZengEuropean Respiratory SocietyERJ Open Research2312-05412019-02-015110.1183/23120541.00248-201800248-2018Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohortTom M.A. Wilkinson0Emmanuel Aris1Simon C. Bourne2Stuart C. Clarke3Mathieu Peeters4Thierry G. Pascal5Laura Taddei6Andrew C. Tuck7Viktoriya L. Kim8Kristoffer K. Ostridge9Karl J. Staples10Nicholas P. Williams11Anthony P. Williams12Stephen A. Wootton13Jeanne-Marie Devaster14The AERIS Study Group:J. AlnajarR. AndersonE. ArisW.R. BallouA. BartonS. BourneM. CaubetS.C. ClarkeD. ClearyC. CohetN.A. CoombsK. CoxJ-M. DevasterV. DevineN. DevosE. DineenT. ElliottR. GladstoneS. HardenJ. JefferiesV.L. KimP. MorisK.K. OstridgeT.G. PascalM. PeetersB. SenteS. SchoonbroodtK.J. StaplesA.C. TuckL. WelchV. WeynantsT.M.A. WilkinsonA.P. WilliamsN.P. WilliamsC. WoelkM. WojtasS.A. Wootton Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK GSK, Wavre, Belgium Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK GSK, Wavre, Belgium GSK, Wavre, Belgium GSK, Sienna, Italy Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK Wessex Investigational Sciences Hub, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, UK Southampton NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK GSK, Wavre, Belgium The association between exacerbation aetiology and exacerbation frequency is poorly understood. We analysed 2-year follow-up data from a prospective observational study of patients with chronic obstructive pulmonary disease (COPD) (www.clinicaltrials.gov identifier number NCT01360398) to evaluate year-to-year variation in exacerbation frequency and related aetiology. A total of 127 patients underwent blood and sputum sampling monthly and at exacerbation to detect respiratory infections and eosinophilic inflammation; 103 continued into year 2 and 88 completed both years. The most common bacterial species at stable state and exacerbation was Haemophilus influenzae. Among infrequent exacerbators (one exacerbation per year), the incidence of viral infection at exacerbation was high (60.0% (95% CI 35.1–81.7%) in year 1 and 78.6% (53.4–94.2%) in year 2). Those with more frequent exacerbations tended to have higher relative incidence of bacterial than viral infection. Patients with at least two additional exacerbations in year 2 versus year 1 had a higher risk of H. influenzae colonisation at stable state than those with at least two fewer exacerbations, as detected by culture (OR 1.43 (95% CI 0.71–2.91) versus 0.63 (0.40–1.01), p=0.06) and PCR (1.76 (95% CI 0.88–3.51) versus 0.56 (0.37–0.86), p<0.01). This was not seen with other infection types or eosinophilic inflammation. Analysis of the same cohort over 2 years showed, for the first time, that changes in yearly COPD exacerbation rate may be associated with variations in H. influenzae colonisation.http://openres.ersjournals.com/content/5/1/00248-2018.full |
| spellingShingle | Tom M.A. Wilkinson Emmanuel Aris Simon C. Bourne Stuart C. Clarke Mathieu Peeters Thierry G. Pascal Laura Taddei Andrew C. Tuck Viktoriya L. Kim Kristoffer K. Ostridge Karl J. Staples Nicholas P. Williams Anthony P. Williams Stephen A. Wootton Jeanne-Marie Devaster The AERIS Study Group: J. Alnajar R. Anderson E. Aris W.R. Ballou A. Barton S. Bourne M. Caubet S.C. Clarke D. Cleary C. Cohet N.A. Coombs K. Cox J-M. Devaster V. Devine N. Devos E. Dineen T. Elliott R. Gladstone S. Harden J. Jefferies V.L. Kim P. Moris K.K. Ostridge T.G. Pascal M. Peeters B. Sente S. Schoonbroodt K.J. Staples A.C. Tuck L. Welch V. Weynants T.M.A. Wilkinson A.P. Williams N.P. Williams C. Woelk M. Wojtas S.A. Wootton Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort ERJ Open Research |
| title | Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort |
| title_full | Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort |
| title_fullStr | Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort |
| title_full_unstemmed | Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort |
| title_short | Drivers of year-to-year variation in exacerbation frequency of COPD: analysis of the AERIS cohort |
| title_sort | drivers of year to year variation in exacerbation frequency of copd analysis of the aeris cohort |
| url | http://openres.ersjournals.com/content/5/1/00248-2018.full |
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