Observational studyThorax2020
Association between COPD exacerbations and lung function decline during maintenance therapy.
Observational study in Thorax, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Remote Patient Monitoring and Machine Learning in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Dual Systematic Literature Review and Narrative Synthesis.Journal of medical Internet research · 2024Pooled it
- Trial
- Cooperation, Defection, and Collapse: A Multiscale Game Theory Framework for Emphysema Progression.Cells · 2026Review
- Genetic variants underpinning lung function decline in the Lifelines general population cohort study.ERJ open research · 2026Article
- COPD Exacerbation Recognition Tool: Translation, Linguistic, and Cross-Cultural Validation.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2026Article
- Characterization of Patients with COPD and GOLD E Classification in the United States.International journal of chronic obstructive pulmonary disease · 2026Article
- Type 2 inflammation in chronic obstructive pulmonary disease: A promising treatable trait and practice recommendations.Chinese medical journal pulmonary and critical care medicine · 2025Article
- Increased risk of acute exacerbation in obstructive airway disease: the impact of metabolic dysfunction-associated steatotic liver disease and small airway dysfunction.BMJ open respiratory research · 2025Article
- Telemonitoring to Reduce COPD Exacerbations: A Work in Progress.Respiratory care · 2025Article
- Pragmatic Evaluation of an Improvement Program for People Living With Modifiable High-Risk COPD Versus Usual Care: Protocols for the Cluster Randomized PREVAIL Trial.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025Article
- Inhibition of IL-4Rα reduces CCL26 in bronchial epithelial cells from COPD patients.ERJ open research · 2025Article
- Delaying disease progression in COPD with early escalation to triple therapy: a modelling study (DEPICT-2).ERJ open research · 2025Article
- Impact of occupational exposures in patients with chronic obstructive pulmonary disease: current understanding and knowledge gaps.Current opinion in pulmonary medicine · 2025Review
- The Burden of COPD with Type 2 Inflammation in North-West Continental Europe.International journal of chronic obstructive pulmonary disease · 2025Review
- Validation and Comparison of BAP-65, DECAF, NEWS, and a Novel Combined Score for Predicting in-Hospital Mortality in Patients with Acute Exacerbation of COPD.International journal of chronic obstructive pulmonary disease · 2025Article
- Estimating rate of lung function change using clinical spirometry data.BMJ open respiratory research · 2024Article
- Monitoring COPD patients: systemic and bronchial eosinophilic inflammation in a 2-year follow-up.BMC pulmonary medicine · 2024Article
- Inhaled Corticosteroids in Subjects with Chronic Obstructive Pulmonary Disease: An Old, Unfinished History.Biomolecules · 2024Review
- Phenotypes, Etiotypes, and Endotypes of Exacerbations of Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2023Review
- Management of comorbidities in difficult and severe asthma.Breathe (Sheffield, England) · 2023Review
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about the impact of exacerbations on COPD progression or whether inhaled corticosteroid (ICS) use and blood eosinophil count (BEC) affect progression. We aimed to assess this in a prospective observational study.
methodsThe study population included patients with mild to moderate COPD, aged ≥35 years, with a smoking history, who were followed up for ≥3 years from first to last spirometry recording using two large UK electronic medical record databases: Clinical Practice Research Datalink (CPRD) and Optimum Patient Care Research Database (OPCRD). Multilevel mixed-effects linear regression models were used to determine the relationship between annual exacerbation rate following initiation of therapy (ICS vs non-ICS) and FEV
resultsOf 12178 patients included (mean age 66 years; 48% female), 8981 (74%) received ICS. In patients with BEC ≥350 cells/µL not on ICS, each exacerbation was associated with subsequent acceleration of FEV
conclusionExacerbations are associated with a more rapid loss of lung function among COPD patients with elevated blood eosinophils, defined as ≥350 cells/µL, not treated with ICS. More aggressive prevention of exacerbations using ICS in such patients may prevent excess loss of lung function.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.