Evidence map›Paper›PMID 40393719›Full record

ArticleThorax2025

Impact of long-term non-invasive ventilation on severe exacerbations and survival in COPD: a French nationwide cohort study using multistate models.

Jean Louis Pépin, Eleonore Herquelot, Helene Denis, Anne Josseran, Florent Lavergne, Adam Benjafield, Atul Malhotra, Janna Raphelson, Peter Cistulli, Aurelie Schmidt and 4 more

Abstract read
In one paragraph

Article in Thorax, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Jean Louis PépinUniversite Grenoble Alpes, Saint-Martin-d'Heres, France jpepin@chu-grenoble.fr.ORCID 0000-0003-3832-2358
Eleonore HerquelotHeva, Lyon, France.
Helene DenisHeva, Lyon, France.
Anne JosseranResMed Science Centre, Saint Priest, France.
Florent LavergneResMed Science Centre, Saint Priest, France.
Adam BenjafieldResMed Science Centre, Bella Vista, New South Wales, Australia.
Atul MalhotraPulmonary and Critical Care, UCSD, La Jolla, California, USA.
Janna RaphelsonPulmonary and Critical Care, UCSD, La Jolla, California, USA.
Peter CistulliCharles Perkins Centre, Faculty of Medicine and Health, Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia.ORCID 0000-0002-7920-4924
Aurelie SchmidtHeva, Lyon, France.
Sebastien BaillyInserm U1300, CHU Grenoble Alpes, Laboratoire HP2, Université Grenoble Alpes, Grenoble, France.ORCID 0000-0002-2179-4650
Alain PalotHopital Saint Joseph, Marseille, France.
Arnaud PrigentPolyclinique Saint Laurent, Rennes, France.ORCID 0000-0001-6302-1130
medXcloud group

Funding

Is Obstructive Sleep Apnea Important in the Development of Alzheimer's DiseaseR01AG063925 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2020 to 2024
$3.7M
Underlying mechanisms of obesity-induced obstructive sleep apneaR01HL148436 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Atul Malhotra · 2020 to 2026
$3.4M
Sleep Apnea Endophenotypes: One Size Does Not Fit AllR01HL154926 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL · 2021 to 2025
$3.3M
The cardiovascular consequences of sleep apnea plus COPD (Overlap syndrome)R01HL166485 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Atul Malhotra · 2023 to 2026
$3.1M
VentNet: A Real-Time Multimodal Data Integration Model for Prediction of Respiratory Failure in Patients with COVID-19R01HL157985 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MALHOTRA, ATUL, NEMATI, SHAMIM · 2022 to 2025
$2.9M
Developing a Diverse Next Generation of Leaders in Respiratory ScienceT32HL166127 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Laura Elise Crotty Alexander, Atul Malhotra · 2023 to 2026
$1.6M
The Left and Right Ventricles in Sleep Apnea with COPDF32HL176079 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI RAPHELSON, JANNA · 2024 to 2025
$167k
NHLBI NIH HHS F32 HL176079NHLBI NIH HHS L30 HL175771NHLBI NIH HHS R01 HL148436NHLBI NIH HHS R01 HL154926NHLBI NIH HHS R01 HL157985NHLBI NIH HHS R01 HL166485NHLBI NIH HHS T32 HL166127NIA NIH HHS R01 AG063925
6 · The paper itself

Abstract

rationaleChronic obstructive pulmonary disease (COPD) is the most common indication for domiciliary non-invasive ventilation (NIV), but long-term outcomes data are limited.

objectiveThis multistate model analysis estimated the impact of NIV therapy continuation versus cessation on transitions between three different disease states.

methodsModel data came from the French national health insurance reimbursement system database for individuals aged ≥40 years with COPD and ≥1 NIV reimbursement in 2015-2019. MEASUREMENT AND MAIN

resultsData from 49 503 patients started on NIV were included (median age 70 years, 51.2% male, median 1 exacerbation in the previous year). There were 80 361 severe exacerbations and 18 125 deaths (including 7805 in severe exacerbation). In multistate models, NIV continuation was associated with a significant reduction in transition to death, from severe exacerbation (HR 0.84, 95% CI 0.79 to 0.91) and without exacerbation (HR 0.88, 95% CI 0.83 to 0.93). NIV continuation versus cessation had no significant effect on transition between without exacerbation to severe exacerbation (HR 0.98, 95% CI 0.95 to 1.00) but was significantly associated with slower transition from severe exacerbation to without exacerbation (HR 0.87, 95% CI 0.84 to 0.89).

conclusionThis multistate model analysis found that the long-term use of domiciliary NIV was associated with a lower risk of transitions to death, but was not associated with a reduction in recovery time after severe exacerbation. These data highlight the potential mortality benefits of long-term domiciliary NIV in COPD and can be used as one piece of evidence to support evidence-based guideline recommendations.

Indexed as

Noninvasive VentilationPulmonary Disease, Chronic ObstructiveAgedCohort StudiesDisease ProgressionFemaleFranceHumansMaleMiddle AgedSurvival RateCOPD ExacerbationsCOPD PathologyNon invasive ventilation

Identifiers

PMID40393719
PMCPMC12421116

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Registered trials

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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.