Quality Of Life In Chronic Obstructive Pulmonary Disease Research Articles

The Short-Term Efficacy of a Three-Week Pulmonary Rehabilitation Program among Patients with Obstructive Lung Diseases.

Introduction: The recommended duration for pulmonary rehabilitation stands at a minimum of six weeks; however, this stipulation may pose constraints in various countries due to financial limitations imposed by insurance companies and/or national health funds, as is the case in Poland. Consequently, our study endeavors to analyze the short-term outcomes stemming from a condensed three-week PR regimen administered to patients diagnosed with chronic obstructive pulmonary disease (COPD), asthma, and the concomitance of these conditions (COPD-A)-this is an approach that is standard in the rehabilitation protocols endorsed by our national health fund. Methods: Patients diagnosed with COPD, asthma, and COPD-A, referred to the PR program, underwent retrospective analysis to evaluate the short-term efficacy of a three-week PR program. Patients underwent comprehensive assessment by respiratory physicians and rehabilitation consultants, leading to individualized PR programs. Clinical evaluations occurred at program onset and completion. Results: 125 patients participated: 37 COPD, 61 asthma, and 27 COPD-A. Significant improvements were observed in the COPD Assessment Test (CAT), the consensus-based GINA symptom control tool (GINA-SCT), the Modified Medical Research Council (mMRC) scale, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), and the 6-min walk test (6 MWT) distance, as well as in the St. George's Respiratory Questionnaire (SGRQ) scores. All groups experienced reduced dyspnea severity and improved exercise tolerance. FEV1 and FVC improved in asthma and COPD-A, but not significantly in COPD. Multivariable logistic regression identified predictive factors for PR response. Conclusions: The study supports the short-term efficacy of the three-week PR program in improving clinical outcomes, exercise tolerance, and quality of life in COPD and asthma patients. Tailoring interventions based on predictors of PR response can optimize outcomes. Further research, particularly of the COPD-A group, is needed for individualized approaches. Larger sample sizes are necessary to confirm our findings.

Higher Plasma Omega-3 Levels are Associated With Improved Exacerbation Risk and Respiratory-Specific Quality of Life in COPD.

Omega-3 polyunsaturated fatty acids (PUFAs) have been associated with systemic anti-inflammatory responses. Dietary intake of omega-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has also been associated with lower COPD morbidity using self-report food frequency questionnaires. To investigate the relationship between measured PUFA intake using plasma EPA+DHA levels and COPD morbidity. Former smokers with moderate-severe COPD living in low-income communities were enrolled in a 6-month prospective cohort study. Participants completed standardized questionnaires, spirometry, and plasma samples at 3-month intervals. Total plasma PUFAs were analyzed using gas chromatography/ mass spectrometry for DHA and EPA concentrations. Linear or logistic mixed model regression was used to evaluate EPA+DHA's and COPD morbidity's association, accounting for demographics, lung function, pack years, comorbidities, and neighborhood poverty. 133 plasma EPA+DHA samples from 57 participants were available. Participants exhibited average plasma EPA and DHA levels of 14.7±7.3 µg/mL and 40.2±17.2 µg/mL, respectively, across the three clinic visits. Each standard deviation increase in EPA+DHA levels was associated with 2.7 points lower SGRQ score (95% CI -5.2, -0.2) and lower odds of moderate exacerbation (OR 0.4; 95% CI 0.2, 0.9) but lacked significant association with CAT score (95% CI -2.4, 0.8), mMRC (95% CI -02, 0.2), or severe exacerbations (95% CI 0.3, 1.4). Plasma EPA+DHA levels are associated with better respiratory-specific quality of life and lower odds of moderate exacerbations in patients with moderate-to-severe COPD. Further research is warranted to investigate the efficacy of an omega-3 dietary intervention in the management of COPD morbidities.

Physical Activity, Depression and Quality of Life in COPD - Results from the CLARA II Study.

Symptoms of depression, pain and limitations in physical activity may affect quality of life in COPD patients independent from their respiratory burden. We aimed to analyze the associations of these factors in outpatients with COPD in Austria in a stable phase of disease. We conducted a national, cross-sectional study among patients with COPD. For depression, the Patient Health Questionnaire-9 (PHQ-9) and for respiratory symptoms the St. George's Respiratory Questionnaire for COPD patients (SGRQ-C) were used along with 10-point scales for physical activity and pain. After exclusion of 211 patients due to non-obstructive spirometry or missing data, 630 patients (62.5% men; mean age 66.8±8.6 (SD) years; mean FEV1%pred. 54.3 ± 16.5 (SD)) were analyzed. Of these, 47% reported one or more exacerbations in the previous year, 10.4% with hospitalization. A negative depression score was found in 54% and a score suggesting severe depression (PHQ-9 score≥15) in 4.7%. In a multivariate linear regression model, self-reported pain, dyspnea, and number of exacerbations were predictors for higher PHQ-9-scores. A negative pain score was found in 43.8%, and a score suggesting severe pain in 2.9% (8-10 points of 10-point scale). Patients reporting severe pain were more often female, had more exacerbations, and reported more respiratory and depressive symptoms, a lower quality of life, and less physical activity. About 46% of patients rated their physical activity as severely impaired. These patients were significantly older, had more exacerbations, concomitant heart disease, a higher pain and depression score, and a lower quality of life (SGRQ-C - total score and all subscores). In Austria, nearly half of stable COPD outpatients reported symptoms of depression, which were associated with lower levels of self-reported physical activity, more pain, and respiratory symptoms. The associations were particularly strong for depression with SGRQ-C.

Myocardial Perfusion is Compromised in Patients with COPD and Associated with Reduced Functional Capacity

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the 3rd leading cause of death worldwide and carries with it significant cardiovascular mortality. Arterial stiffness is a known risk factor for cardiovascular disease that contributes to worsening myocardial blood flow and limits functional capacity, a marker of disease prognosis and quality of life in COPD. Myocardial perfusion is decided by a careful balance between myocardial blood flow and workload and has been strongly associated with cardiovascular mortality. Despite the convincing relationship between COPD and cardiovascular disease, to date, studies investigating myocardial perfusion and its relationship to functional capacity in COPD remains unexplored. Purpose: This study sought to test the hypothesis that myocardial perfusion is reduced in COPD and associated to functional capacity. Methods: Ten patients with COPD (GOLD Stage II-IV) with no overt signs of cardiovascular disease or diagnosis and 10 demographically matched, apparently healthy controls participated in this study completing a comprehensive analysis of vascular function and functional capacity. Carotid femoral applanation tonometry was used to assess myocardial perfusion (subendocardial viability ratio (SEVR)) and arterial stiffness (Pulse Wave Velocity (PWV)). Functional Capacity was measured via six-minute walk test distance (6MWT) with dyspnea being measured on a 0-10 scale. Results: Patients with COPD exhibited significantly ( p=0.041) reduced myocardial perfusion (SEVR: ΔCOPD=131±19% vs. ΔControl=153±28%) and increased arterial stiffness (PWV: ΔCOPD=8±1 m/s vs. ΔControl=6±1 m/s, p=0.013) when compared to matched controls. Functional Capacity was significantly ( p<0.001) reduced in patients with COPD (6MWT Distance: ΔCOPD=274±87 m vs. ΔControl=476±99 m) while exhibiting significantly ( p=0.02) increased post exercise dyspnea (ΔCOPD=3.1±2.4 vs. ΔControl=0.8±1.2 a.u.). Myocardial perfusion was strongly associated to 6MWT distance ( p=0.038; r=0.693) and arterial stiffness was negatively associated with dyspnea ( p=0.015; r=-0.850). Conclusion: Our data supports that patient with COPD exhibit poor myocardial perfusion that is associated to worse functional capacity, key component of quality of life and mortality in this population. This preliminary data highlights the importance of cardiovascular screening in COPD as it emphasizes how myocardial perfusion impairments may predict prognosis in this population even when no diagnosis of cardiovascular disease is present. Future studies are warranted to investigate if impaired myocardial perfusion plays a causational role in decreasing functional capacity and its potential as a therapeutic target. Supported by American Heart Association (18CDA34110323 PRM & PRE905812 KC/PRM). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

To compare the effect of upper limb induced breathing exercise in reverse pattern v/s breathing exercise in normal pattern on dyspnea, pulmonary function and quality of life in COPD

To compare the effect of upper limb induced breathing exercise in reverse pattern v/s breathing exercise in normal pattern on dyspnea, pulmonary function and quality of life in COPD

Relationship among Body Composition, Adipocytokines, and Irisin on Exercise Capacity and Quality of Life in COPD: A Pilot Study

Adipose tissue is an endocrine organ that interferes with the severity of chronic obstructive pulmonary disease (COPD). Although inflammatory markers, body composition, and nutritional status have a significant impact on pulmonary function, the real contribution of adipocytokines and myokines in COPD is still controversial. We aimed to evaluate the role played by the body composition, leptin, adiponectin, haptoglobin, and irisin on the functional exercise capacity, respiratory function, and quality of life (QoL) in COPD. In 25 COPD (20% GOLD-1; 60% GOLD-2; 20% GOLD-3) patients and 26 matched control subjects, we find that leptin, total adiponectin and haptoglobin are significantly increased whereas the 6 min walk test (6MWT) and physical functioning scores are significantly decreased in COPD versus controls. A significant positive relationship is found between leptin and fat mass and between 6MWT and the good health indicators of nutritional status. A significant inverse relationship is found between 6MWT and leptin and fat mass, FEV1 and haptoglobin, and irisin and haptoglobin. Phase angle and leptin level are significant predictors for functional exercise capacity assessed with 6MWT. Taken altogether, the results of this pilot study further support the role played by body composition and adipocytokines on exercise capacity respiratory function and QoL in COPD.

Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial

IntroductionPhysical and mental health are often affected in chronic obstructive pulmonary disease (COPD) adversely affecting disease course and quality of life. Abnormalities in whole body and cellular energy metabolism, dietary...

Differences in Sedentary Time, Light Physical Activity, and Steps Associated with Better COPD Quality of Life.

There is a knowledge gap about how much physical activity is recommended to patients with chronic obstructive pulmonary disease (COPD). We asked, what is the average difference in sedentary time and physical activity associated with clinically meaningful differences in symptoms in a large, well-characterized cohort of patients with advanced COPD? We conducted a cross-sectional analysis of daily activity data in 292 patients with stable COPD. Activity measure coefficients from multivariable linear models were used to predict the average difference in activity between patients with twice the minimal clinically important difference in reported symptoms. Symptoms were assessed with the Chronic Respiratory Disease Questionnaire subdomains - dyspnea, fatigue, mastery, and emotions. Daily steps, minutes in light physical activity, and sedentary time were measured by triaxial accelerometers. Average sedentary time, light physical activity, and steps were 767.6 minutes, 177.7 minutes, and 2960 steps, respectively. Individuals with 1-point better dyspnea scores averaged 24.5 (8.4-40.5) minutes less sedentary time per day. Individuals with 1-point better dyspnea and fatigue scores averaged 21.5 (10.9-32.3) minutes or 12.5 (2.0-23.2) minutes more light physical activity per day, respectively. Individuals with 1-point better dyspnea, fatigue, mastery, and emotions scores averaged 762 (546-984), 579 (351-814), 418 (207-636), and 392 (157-634) more steps per day, respectively. We provide guidance to clinicians counseling patients with severe COPD in activity-related goal setting on sedentary time, light physical activity, and steps associated with better symptoms.

Anthropometric, Psychosocial, Physiological, and Postural Observances During Ramadan in Men With Chronic Obstructive Pulmonary Disease.

This study aimed to carry out a Ramadan observance (RO) on anthropometric, psychosocial, physiological, and postural characteristics of patients with chronic obstructive pulmonary disease (COPD). Twenty COPD patients were evaluated. Tests performed 1 week before Ramadan (C), and during the second (R-2) and the fourth weeks of Ramadan (R-4) included standard anthropometry, spirometry, a quality of life questionnaire (VQ11), a 6-minute walking test (6MWT), measurement of maximal voluntary contraction force of the quadriceps (MVC), Timed Get Up and Go (TUG), Berg Balance Scale (BBS), and Unipedal Stance (UST). During R-2, there were significant decreases in forced vital capacity and forced expiratory volumes, 6MWT distance, MVC, BBS, and UST, with significant increases in TUG and significant changes in VQ11. During R-4, there was some recovery, but all variables remained significantly different from initial control data. To conclude, RO adversely affects pulmonary function, exercise performance, postural balance, and quality of life in COPD, with some recovery by the R-4. Although a number of functional consequences remain to be elucidated, functional losses were insufficient to limit daily living in our sample, but further studies are recommended in those with more severe COPD, paying particular attention to postural disturbances and a possible increase in the risk of falls.

Efficacy of Web-Based Supportive Interventions in Quality of Life in COPD Patients, a Systematic Review and Meta-Analysis.

Background: Adults living with Chronic Obstructive Pulmonary Disease (COPD) often have difficulties when trying to access health care services. Interactive communication technologies are a valuable tool to enable patients to access supportive interventions to cope with their disease. The aim of this revision and meta-analysis is to analyze the content and efficacy of web-based supportive interventions in quality of life in COPD. Methods: Medline (via PubMed), Web of Science, and Scopus were the databases used to select the studies for this systematic review. A screening, analysis, and assessment of the methodological quality was carried out by two independent researchers. A meta-analysis of the extracted data was performed. Results: A total of 9 of the 3089 studies reviewed met the inclusion criteria. Most repeated web content elements were educational and involved communication with healthcare professional content. Finally, seven of the nine studies were included in a quantitative analysis. Web-based supportive interventions significantly improved quality of life when added to usual care (SMD = −1.26, 95% CI = −1.65, −0.86; p < 0.001) but no significant differences were found when compared with an autonomous pedometer walking intervention (p = 0.64) or a face-to-face treatment (p = 0.82). Conclusion: This systematic review and meta-analysis suggests that web-based supportive interventions may complement or accompany treatments in COPD patients due to the advantages of online interventions. The results obtained should be treated with caution due to the limited number of studies in this area and methodological weaknesses.

Rhinosinusitis without nasal polyps is associated with poorer health-related quality of life in COPD

Rhinosinusitis without nasal polyps (RSsNP) is prevalent in COPD. Previous studies on its association with health-related quality of life (HRQoL) have limitations, and RSsNP is currently not recognized as a comorbidity. This study investigates HRQoL in COPD including a focus on RSsNP.Generic HRQoL was assessed with the Short Form-36 (SF-36v2) questionnaire and compared between 90 COPD and 93 control subjects and in subgroups with and without RSsNP. The association between RSsNP and COPD versus not and generic HRQoL was assessed by multivariable linear regression with adjustments for age, education, and body mass index (BMI). Disease-specific HRQoL was assessed by Sinonasal outcome test-22 (SNOT-22), St. Georges Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT) and compared between COPD with and without RSsNP, and their association to RSsNP was assessed by multivariable linear regression with adjustments for age, BMI, and FEV1% predicted.RSsNP was associated with poorer disease-specific HRQoL, with higher SNOT-22 total score (14.67 points; 95% CI, 7.06–22.28; P < .001) and psychological subscale score (3.24 points; 95% CI, 0.37–6.11; P = .03), SGRQ symptom score (13.08 points; 95% CI, 2.73–23.4; P = .014), and CAT score (4.41 points; 95% CI, 1.15–7.66; P = .009).Generic HRQoL was poorer in COPD patients than in the control subjects. In addition to COPD, concomitant RSsNP was associated with poorer physical functioning, general health, vitality, and physical component summary.RSsNP in COPD is associated with poorer disease-specific HRQoL that is clinically relevant and, as it is amenable for treatment, should be recognized as a comorbidity of COPD.

Impact of Frailty on Hippocampal Volume in Patients with Chronic Obstructive Pulmonary Disease.

Brain frailty may be related to the pathophysiology of poor clinical outcomes in chronic obstructive pulmonary disease (COPD). This study examines the relationship between hippocampal subfield volumes and frailty and depressive symptoms, and their combined association with quality of life (QOL) in patients with COPD. The study involved 40 patients with COPD. Frailty, depressive symptoms and QOL were assessed using Kihon Checklist (KCL), Hospital Anxiety and Depression Scale (HADS), and World Health Organization Quality of Life Assessment (WHO/QOL-26). Anatomical MRI data were acquired, and volumes of the hippocampal subfields were obtained using FreeSurfer (version 6.0). Statistically, HADS score had significant association with WHO/QOL-26 and KCL scores. KCL scores were significantly associated with volumes of left and right whole hippocampi, presubiculum and subiculum, but HADS score had no significant association with whole hippocampi or hippocampal subfield volumes. Meanwhile, WHO/QOL-26 score was significantly associated with volume of the left CA1. There was a significant association between frailty, depression, and QOL. Hippocampal pathology was related to frailty and, to some extent, with QOL in patients with COPD. Our results suggest the impact of frailty on hippocampal volume and their combined associations with poor QOL in COPD.

Clinical trial on the effects of oral magnesium supplementation in stable-phase COPD patients

Background and aimsCOPD is a common chronic condition in older age that impacts on daily activities and quality of life. Previous studies suggest that magnesium deficit in COPD patients affects bronco-obstruction, inflammation, and physical performance. We investigated whether oral magnesium supplementation in stable-phase COPD patients improves lung function, physical performance, and quality of life.MethodsWe conducted a double-blind randomized-controlled clinical study with 49 participants divided into two groups: one given 300 mg/day of magnesium citrate (n = 25) and the other one sachet/day of a placebo (n = 24). The following parameters were assessed at baseline and after 3 and 6 months: lung function (spirometry), physical performance (handgrip strength, lower limb strength, six-minute walk test), inflammation (e.g., C-reactive protein, CRP), disease-related symptoms, and quality of life (St George’s Respiratory Questionnaire, EuroQoL-5D, the Modified British Medical Research Council Questionnaire).ResultsLinear mixed models revealed significantly lower CRP values in the intervention group than in the placebo group at the 6 month follow-up (β = − 3.2, 95% CI − 6.0, − 0.4, p = 0.03). Moreover, the maximum work for flexion tended to increase in both groups between the 3 and the 6 month assessments, especially in the placebo group. No significant differences within and between groups over the study period were observed for the other parameters tested.ConclusionsAlthough the established minimum sample size was not reached, our results suggests that oral magnesium supplementation may have a potential anti-inflammatory role. On the other hand, it does not seem to substantially influence lung function, physical performance, and quality of life in COPD patients.Trial registrationThe study is registered in clinicaltrial.gov (Trial Registration: NCT02680769, 13 June 2016, retrospectively registered).

Impact of pulmonary rehabilitation in sleep in COPD patients measured by actigraphy.

Chronic obstructive pulmonary disease (COPD) patients have poor sleep quality, longer time to sleep onset and frequent nocturnal awakenings. Poor sleep quality in COPD is associated with poor quality of life (QoL), increased exacerbations and increased mortality. Pulmonary rehabilitation (PR) improves functional status and QoL in COPD but effects on sleep are unclear. PR improves subjective sleep quality but there is paucity of objective actigraphy data. We hypothesized that actigraphy would demonstrate subjective and objective improvement in sleep following PR. Paired comparisons (t-test or Wilcoxon-signed-rank test) were performed before and after PR data on all variables. This retrospective study of COPD patients undergoing PR utilized actigraphy watch recordings before and after 8-weeks of PR to assess changes in sleep variables including total time in bed (TBT), total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), wakefulness after sleep onset (WASO) and total nocturnal awakenings. A change in Pittsburg Sleep Quality Index (PSQI) was a secondary outcome. PSQI was performed before and after PR. Sixty-nine patients were included in the final analysis. Most participants were male (97%), non-obese (median BMI 27.5, IQR 24.3 to 32.4 kg/m2) with an average age of 69 ± 8 years and 71% had severe COPD (GOLD stage 3 or 4). Prevalence of poor sleep quality (PSQI ≥5) was 86%. Paired comparisons did not show improvement in actigraphic sleep parameters following 8-weeks PR despite improvements in 6-min-walk distance (6MWD, mean improvement 54 m, 95% CI 34 m to 74 m, p<0.0001) and St. George's Respiratory Questionnaire scores (SGRQ, mean improvement 7.7 points, 95% CI 5.2 to 10.2, p<0.0001). Stratified analysis of all sleep variables by severity of COPD, BMI, mood, mental status, 6-MWD and SGRQ did not show significant improvement after PR. In Veterans with poor sleep quality (PSQI ≥ 5), PR improved subjective sleep quality (PSQI, mean difference 0.79, 95% CI 0.07 to 1.40, p = 0.03). Pulmonary rehabilitation improved subjective sleep quality in Veterans who had poor sleep quality at the beginning of the PR but did not improve objective sleep parameters by actigraphy. Our findings highlight the complex interactions among COPD, sleep and exercise.

Effect of Whole Body Vibration on Exercise Capacity and Quality ofLife in Obstructive Lung Disease

AbstractBackground: Skeletal muscle dysfunction in COPD dete-riorate the symptoms and quality of life of patients. Exerciseis a basic unit of Pulmonary rehabilitation causing improvemuscle strength, exercise capacity, health status and reducinghospital readmission rate. Despite the benefits of exercisetraining, patients are not able to perform due to high levelsof perceived dyspnea, fatigue, and fear of breathlessness.Whole-body vibration exercise have similar response produced by other modes of physical activity. This study aim to clarify the effect of Whole Body Vibration on exercise capacity and quality of life in COPD patients.Aim of Study: To compare the effect of Whole BodyVibration to traditional exercise protocol on exercise capacityand quality of life with COPD patients.Subject and Procedures: 30 COPD patients stage I & II (GOLD 2018) were assigned into two equal groups in numberperformed 3 session/week for 6 weeks. Group (A) receivedSquat exercises program on Whole Body Vibration 5-10minutes with six series of 30s with 60s of rest between eachseries, and frequency 24Hz in addition to traditional chestphysiotherapy including Diaphragmtic breathing, cycling,strengthening for lower limbs while group (B) received thesame training on the floorin addition to traditional chestphysiotherapy before and after the 18th sessionsthe parameter of. Six minute walk distance test (6 MWDT), 5 repetition sit to stand test (5RSTS) and COPD assessment test (CAT) were also measured.Results: In study group Group (A) showed significantincreases in 6 MWDT, 5 RSTS and CAT, 27.36%, 25.46%, 36.67% respectively & in control group Group (B) showedsignificant increase 21.98%, 18.6%, 30.63% respectively,comparing between the two groups there were significantdifferences in 6 MWD and 5 RSTS, while non significantdifference in CAT.Conclusion: Whole Body Vibration training was goodcomplementary training exercise, which improve ventilatoryfunctions, enhances exercise capacity and quality of life forCOPD patients.

Treatable traits in an English cohort: prevalence and predictors of future decline in lung function and quality of life in COPD.

Background“Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease, in order to determine the core traits associated with disease outcomes where targeted treatments may be applied.ObjectivesTo determine the prevalence of TTs in chronic obstructive pulmonary disease (COPD) and which traits predict future decline in lung function and quality of life (QoL).MethodsA 4-year longitudinal evaluation was conducted using data from 3726 participants in the English Longitudinal Study of Ageing (ELSA). TTs were identified based on published recommendations. Traits that predicted decline in lung function and QoL were analysed using generalised estimating equations.ResultsOverall, 21 TTs, including pulmonary (n=5), extra-pulmonary (n=13) and behavioural/lifestyle risk-factors (n=3) were identified. In multivariate analyses, the traits of chronic bronchitis (β −0.186, 95% CI −0.290 to −0.082), breathlessness (β −0.093, 95% CI −0.164 to −0.022), underweight (β −0.216, 95% CI −0.373 to −0.058), sarcopenia (β −0.162, 95% CI −0.262 to −0.061) and current smoking (β −0.228, 95% CI −0.304 to −0.153) predicted decline in forced expiratory volume in 1 s (FEV1). Of the seven traits that predicted decline in QoL, depression (β −7.19, 95% CI −8.81 to −5.57) and poor family and social support (β −5.12, 95% CI −6.65 to −3.59) were the strongest.ConclusionThe core TTs of COPD associated with a decline in lung function and QoL were identified. Targeting these impactful traits with individualised treatment using a precision medicine approach may improve outcomes in people with COPD.

The relationship between body mass index and health-related quality of life in COPD: real-world evidence based on claims and survey data

BackgroundBody mass index (BMI) is an important parameter associated with mortality and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD). However, informed guidance on stratified weight recommendations for COPD is still lacking. This study aims to determine the association between BMI and HRQoL across different severity grades of COPD to support patient management.MethodsWe use conjunct analysis of claims and survey data based on a German COPD disease management program from 2016 to 2017. The EQ-5D-5L visual analog scale (VAS) and COPD Assessment Test (CAT) are used to measure generic and disease-specific HRQoL. Generalized additive models with smooth functions are implemented to evaluate the relationship between BMI and HRQoL, stratified by COPD severity.Results11,577 patients were included in this study. Mean age was 69.4 years and 59% of patients were male. In GOLD grades 1–3, patients with BMI of around 25 had the best generic and disease-specific HRQoL, whereas in GOLD grade 4, obese patients had the best HRQoL using both instruments when controlled for several variables including smoking status, income, COPD severity, comorbidities, emphysema, corticosteroid use, and days spent in hospital.ConclusionThis real-world analysis shows the non-linear relationship between BMI and HRQoL in COPD. HRQoL of obese patients with mild to severe COPD might improve following weight reduction. For very severe COPD, a negative association of obesity and HRQoL could not be confirmed. The results hint at the need to stratify COPD patients by disease stage for optimal BMI management.

Effects of calisthenics on exercise capacity, symptoms and quality of life in COPD

Chronic Obstructive Pulmonary Disease (COPD) is the leading cause of death and disability in India. The study aims to evaluate the effects of CSC- COPD Sitting Calisthenics on exercise capacity, symptoms and quality of life. Twenty-five patients with COPD admitted in SRM Medical college hospital, and research centre (Department of respiratory medicine) were included in the study. After calculating the samples of 25 with excluding one drop outpatient, randomly assigned 12 patients in each group, group A (n = 12), group B (n = 12) and the patients in two groups received five sessions of intervention (CSC and CET) in the hospital stay. The results indicate that there is a significant improvement in exercise capacity in callisthenics group on day 5 (P &amp;lt; 0.001). There was no significant difference found for modified Borg's scale on day 5 in callisthenics group. QOL showed a statistically significant difference in Group A, and the current study concludes that callisthenics is effective in improving exercise capacity and QOL in patients diagnosed with COPD.

ENSIFENTRINE ADDED TO TIOTROPIUM OVER 4 WEEKS PROVIDES ADDITIONAL IMPROVEMENT IN COPD QUALITY OF LIFE

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Ensifentrine (RPL554) is an investigational, first-in-class, inhaled dual inhibitor of PDE 3 and 4 that combines bronchodilator and anti-inflammatory actions in a single compound. Results from a dose-ranging study demonstrated that twice-daily nebulised ensifentrine delivered clinically meaningful and significant improvements vs placebo (tiotropium) in lung function and quality of life when added to once-daily tiotropium over 4 weeks. This abstract reports on the effect on quality of life (St. George’s Respiratory Questionnaire for COPD patients; SGRQ-C) of ensifentrine when added to tiotropium. METHODS: This double-blind, placebo-controlled, parallel-group study enrolled COPD patients 40-80 years old, current and former smokers with a smoking history of ≥10 pack years, post-albuterol FEV1 30-70% predicted and FEV1/FVC ≤0.7. Following a 2-week run-in on tiotropium, symptomatic patients (mMRC≥2) with FEV1 30-70% predicted were randomized to receive once-daily tiotropium (Spiriva® Respimat®) plus nebulised ensifentrine (0.375, 0.75, 1.5, or 3 mg) or placebo twice daily for 4 weeks. SGRQ-C responses were collected at randomization and weeks 2 and 4. Means were calculated for the total and sub-domain scores and responder analyses for the proportion of patients that met specific minimal clinically important difference (MCID) were performed. RESULTS: Clinically meaningful and statistically significant improvements in SGRQ-C were observed over tiotropium alone (placebo), exceeding the MCID of 4 units at week 4 with the placebo-corrected change from baseline for the highest doses (1.5 mg: -4.755, p=0.0121; 3 mg: -4.047, p=0.0328). Placebo-corrected change from baseline in week 4 SGRQ-C subscales scores showed significant improvements in the impacts (1.5 mg: -4.396, p=0.0328; 3 mg: -4.981, p=0.0164) and activity (3 mg: -5.141, p=0.0466) scores. A week 4 analysis in patients that improved by at least 4, 8 and 12 units showed higher proportion of responders with at least 4 and 8 units improvement. However, in the analysis for responders with at least 12 units improvement, the difference was much more pronounced in favor of ensifentrine (0.375 mg: 24.3%, p= 0.0119; 0.75 mg: 12.9%; 1.5 mg: 13.9%; 3 mg: 20.5%) compared to placebo (tiotropium alone, 9.8%). CONCLUSIONS: Combined with a significant and clinically meaningful bronchodilator effect, ensifentrine also shows positive trends in COPD symptoms, activity and impacts related to COPD when added onto tiotropium, including a marked improvement in SGRQ-C Total Score of ≥12 units (so-called super responders) in >20% of patients treated with ensifentrine 3 mg added on to tiotropium compared to less than 10% in patients treated with placebo + tiotropium. CLINICAL IMPLICATIONS: Data demonstrates that ensifentrine added to tiotropium over 4 weeks provides additional improvement in COPD quality of life in symptomatic COPD patients. DISCLOSURES: Consultant relationship with Verona Pharma Please note: $5001 - $20000 Added 06/01/2020 by Thomas Bengtsson, source=Web Response, value=Consulting fee Employee relationship with Verona pharma Please note: >$100000 by Tara Rheault, source=Admin input, value=Stock Employee relationship with Verona Pharma Please note: >$100000 Added 05/20/2020 by Kathleen Rickard, source=Web Response, value=Salary

Correlation between serum vitamin C level and COPD assessment test score in chronic obstructive pulmonary disease patients

Background: COPD is a disease due to oxidative stress causing low pulmonary function, resulting in low quality of life. A standard test to measure the quality of life in COPD is COPD Assessment Test (CAT). Vitamin C as antioxidant is widely available in the pulmonary epithelial fluid. This study aimed to investigate the correlation between serum vitamin C level and CAT score in COPD.Methods: This cross-sectional study was conducted at Persahabatan Hospital, East Jakarta, involving 47 subjects using consecutive sampling method. Interview was used to assess subjects’ characteristics and vitamin C intake using semi-quantitative FFQ. Clinical classification, lung function, comorbidity, and CAT scores were gathered from medical records or interview. BMI was used to determine nutritional status, while vitamin C serum level was assessed using spectrophotometry. Results and conclusions: All subjects were male, mean age was 66.6 years, mostly ex-heavy smokers, with decreased lung function, and 25% were undernourished. Vitamin C intake was sufficient, but low in serum vitamin C level and CAT score.There was no correlation between serum vitamin C level and CAT score.