Predictors of Single Bronchodilation Treatment Response for COPD: An Observational Study with the Trace Database Cohort

Laura Carrasco Hernández, Candela Caballero Eraso, Borja Ruiz-Duque, María Abad Arranz, Eduardo Márquez Martín, Carmen Calero Acuña, Jose Luis Lopez-Campos, Laura Carrasco Hernández, Candela Caballero Eraso, Borja Ruiz-Duque, María Abad Arranz, Eduardo Márquez Martín, Carmen Calero Acuña, Jose Luis Lopez-Campos

Abstract

Chronic obstructive pulmonary disease (COPD) patients constitute a heterogeneous population in terms of treatment response. Our objective was to identify possible predictive factors of response to treatment with single bronchodilation monotherapy in patients diagnosed with COPD. The Time-based Register and Analysis of COPD Endpoints (TRACE; clinicaltrials.gov NCT03485690) is a prospective cohort of COPD patients who have been attending annual visits since 2012. Patients who were kept on a single bronchodilator during the first year of follow-up were selected. The responders were defined according to all of the following variables: any improvement in morning post-dose forced expiratory volume in 1 s or deterioration <100 mL, no change or improvement in dyspnea score, and no occurrence of exacerbations. Significant and plausible variables were analyzed using a proportional hazard Cox regression for single bronchodilator responders. We analyzed 764 cases, of whom 128 (16.8%) were receiving monotherapy with one bronchodilator. Of these, 85 patients (66.4%) were responders. Factors affecting responder status were: female gender (hazard ratio (HR) 0.276; 95% confidence interval (CI) 0.089-0.858), dyslipidemia (HR 0.436; 95%CI 0.202-0.939), not performing regular exercise (HR 0.523; 95%CI 0.254-1.076), active smoking (HR 0.413; 95%CI 0.186-0.920), and treatment adherence (HR 2.527; 95%CI 1.271-5.027). The factors associated with a single bronchodilation response are mainly non-pharmacological interventions and comorbidities.

Keywords: COPD; clinical response; long-acting bronchodilators; pharmacological.

Conflict of interest statement

J.L.L.-C. has received fees in the last 3 years for giving lectures, scientific advice, participation in clinical studies, or writing publications for (alphabetical order): AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, Esteve, Ferrer, Gebro, GlaxoSmithKline, Grifols, Menarini, Novartis, Rovi, and Teva. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Forest plot showing the results of the Cox proportional hazard regression of factors associated with being a responder to single bronchodilation as a treatment for COPD. Note: HR—hazard ratio; CI—confidence interval.

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