What is an exacerbation of COPD?

European Respiratory Review

Volumn 13, Issue 88, 2004, Pages 6-13

  Vestbo, J ^a,b  

^a North West Lung Centre ^*  (United Kingdom)

^b WYTHENSHAWE HOSPITAL   (United Kingdom)

Author keywords

Combination therapy; COPD; Exacerbations; Health related quality of life; Inhaled corticosteroids; Long acting 2 agonists

Indexed keywords

ANTIBIOTIC AGENT; BETA 2 ADRENERGIC RECEPTOR STIMULATING AGENT; BUDESONIDE; BUDESONIDE PLUS FORMOTEROL; CORTICOSTEROID; FLUTICASONE PROPIONATE; FORMOTEROL; PLACEBO;

CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL TRIAL; CONFERENCE PAPER; DEATH; DISEASE COURSE; DISEASE EXACERBATION; DISEASE SEVERITY; EOSINOPHIL; HEALTH STATUS; HOSPITALIZATION; HUMAN; LUNG FUNCTION; MORTALITY; SYMPTOM;

EID: 2442601532     PISSN: 09059180     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Conference Paper

References (81)

1. Anto JM, Vermeire P, Vestbo J, Sunyer J. Epidemiology of chronic obstructive pulmonary disease. Eur Respir J 2001; 17: 982-994.
2. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: NHLBI/WHO workshop report, NIH publication No. 2701. Bethesda: US Department of Health and Human Services, 2001.
3. World Health Organization. World Health Report 2002. Geneva: World Health Organization, 2002. www.who.int/whr/2002/en/. Date last accessed: 22 Oct 2003.
4. Seemungal TA, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 1418-1422.
5. Seemungal TAR, Donaldson GC, Bhowmik A, Jeffries DJ, Wedzicha JA. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000; 161: 1608-1613.
6. Burge S, Wedzicha JA. COPD exacerbations: definitions and classifications. Eur Respir J 2003; 21: Suppl 41, 46s-53s.
7. Vestbo J. Epidemiology of exacerbations in COPD. In: Siafakas N, Anthonisen N, Georgopoulos D, Eds. Acute exacerbations of chronic obstructive pulmonary disease. New York: Marcel Dekker Inc, 2003.
8. Rodriguez-Roisin R. Toward a consensus definition for COPD exacerbations. Chest 2000; 117: 398-401S.
9. Anthonisen NR, Manfreda J, Warren CPW, Hershfield ES, Harding GK, Nelson NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196-204.
10. Paggiaro PL, Dahle R, Bakran I, Frith L, Hollingworth K, Efthimiou J. Multicentre randomised placebo-controlled trial of inhaled fluticasone propionate in patients with chronic obstructive pulmonary disease. International COPD Study Group. Lancet 1998; 351: 773-780.
11. Burge PS, Calverley PMA, Jones PW, Spencer S, Anderson JA, Maslen TK. Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive airways disease: the ISOLDE trial. BMJ 2000; 320: 1297-1303.
12. Calverley P, Pauwels R, Vestbo J, et al. Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 2003; 361: 449-456.
13. Calverley PM, Boonsawat W, Cseke Z, Zhong N, Peterson S, Olsson H. Maintenance therapy with budesonide and formoterol in chronic obstructive pulmonary disease. Eur Respir J 2003; 22: 912-919.
14. Szafranski W, Cukier A, Ramirez A, et al. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J 2003; 21: 74-81.
15. Casaburi R, Mahler DA, Jones PW, et al. A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease. Eur Respir J 2002; 19: 217-224.
16. Rennard S, Decramer M, Calverley PM, et al. Impact of COPD in North America and Europe in 2000: subjects' perspective of confronting COPD International Survey. Eur Respir J 2002; 20: 799-805.
17. Donaldson GC, Seemungal TA, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57: 847-852.
18. Garcia-Aymerich J, Monsó E, Marrades RM, et al. Risk factors for hospitalisation for a chronic obstructive disease exacerbation. EFRAM study. Am J Respir Crit Care Med 2001; 164: 1002-1007.
19. Pauwels R, Löfdahl C-G, Svennson K, Carlsson L-G, Stähl E. Symptoms, but not PEF, change during an exacerbation in COPD. Eur Respir J 2003; 22: Suppl. 45, 238s.
20. Wedzicha JA. Exacerbations: etiology and pathophysiologic mechanisms. Chest 2002; 121: Suppl. 5, 136S-141S.
21. White AJ, Gompertz S, Stockley RA. Chronic obstructive pulmonary disease. 6: The aetiology of exacerbations of chronic obstructive pulmonary disease. Thorax 2003; 58: 73-80.
22. Seemungal TA, Harper-Owen R, Bhowmik A, Jeffries DJ, Wedzicha JA. Detection of rhinovirus in induced sputum at exacerbation of chronic obstructive pulmonary disease. Eur Respir J 2000; 16: 677-683.
23. Monso E, Ruiz J, Rosell A, et al. Bacterial infection in chronic obstructive pulmonary disease. A study of stable and exacerbated outpatients using the protected specimen brush. Am J Respir Crit Care Med 1995; 152: 1316-1320.
24. Patel IS, Seemungal TA, Wilks M, Lloyd-Owen SJ, Donaldson GC, Wedzicha JA. Relationship between bacterial colonisation and the frequency, character and severity of COPD exacerbations. Thorax 2002; 57: 759-764.
25. Lams BE, Sousa AR, Rees PJ, Lee TH. Subepithelial immunopathology of the large airways in smokers with and without chronic obstructive pulmonary disease. Eur Respir J 2000; 15: 512-516.
26. Zhu J, Yu Sheng Q, Majumdar S, et al. Exacerbations of bronchitis: bronchial eosinophilia and gene expression for interleukin-4, interleukin-5 and eosinophilia chemoattractants. Am J Respir Crit Care Med 2001; 164: 109-116.
27. Louis RE, Cataldo D, Buckley MG, et al. Evidence of mast-cell activation in a subset of patients with eosinophilic chronic obstructive pulmonary disease. Eur Respir J 2002; 20: 325-331.
28. Turato G, Zuin R, Miniati M, et al. Airway inflammation in severe chronic obstructive pulmonary disease: relationship with lung function and radiologic emphysema. Am J Respir Crit Care Med 2002; 166: 105-110.
29. Bhowmik A, Seemungal TAR, Sapsford RJ, Wedzicha JA. Relation of sputum inflammatory markers to symptoms and lung function changes in COPD exacerbations. Thorax 2000; 55: 114-120.
30. Aaron SD, Angel JB, Lunau M, et al. Granulocyte inflammatory markers and airway infection during acute exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 163: 349-355.
31. Roland M, Bhowmik A, Sapsford Sputum RJ, et al. Sputum and plasma endothelin-1 levels in exacerbations of chronic obstructive pulmonary disease. Thorax 2001; 56: 30-35.
32. Chung KF. Cytokines in chronic obstructive pulmonary disease. Eur Respir J 2001; 18: Suppl 34, 50s-59s.
33. Qiu Y, Zhu J, Bandi V, et al. Biopsy neutrophilia, chemokine and receptor gene expression in severe exacerbations of COPD. Am J Respir Crit Care Med 2003; 168: 968-975.
34. Nagai A, Thurlbeck WM, Konno K. Responsiveness and variability of airflow obstruction in chronic obstructive pulmonary disease. Clinicopathologic correlative studies. Am J Respir Crit Care Med 1995; 151: 635-639.
35. Sitkauskiene B, Sakalauskas R, Malakauskas K, Lötvall J. Reversibility to a beta 2-agonist in COPD: relationship to atopy and neutrophil activation. Respir Med 2003; 97: 591-598.
36. Saetta M, Di Stefano A, Maestrelli P, et al. Airway eosinophilia in chronic bronchitis during exacerbations. Am J Respir Crit Care Med 1994; 150: 1646-1652.
37. Davies L, Angus RM, Calverley PM. Oral corticosteroids in patients admitted to hospital with exacerbations of chronic obstructive pulmonary disease: a prospective randomised controlled trial. Lancet 1999; 354: 456-460.
38. Niewoehner DE, Erbland ML, Deupree RH, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. N Engl J Med 1999; 340: 1941-1947.
39. Jeffery PK. Remodeling in asthma and chronic obstructive lung disease. Am J Respir Crit Care Med 2001; 164: S28-S38.
40. Turato G, Zuin R, Saetta M. Pathogenesis and pathology of COPD. Respiration 2001; 68: 117-128.
41. Fletcher C, Peto R, Tinker C, Speizer FE. The Natural History of Chronic Bronchitis and Emphysema. London: Oxford University Press, 1976.
42. Vestbo J, Prescott E, Lange P, and The Copenhagen City Heart Study Group. Association of chronic mucus hypersecretion with FEVI decline and COPD morbidity. Am J Respir Crit Care Med 1996; 153: 1530-1535.
43. Kanner RE, Anthonisen NR, Connett JE, Lung Health Study Research Group. Lower respiratory illnesses promote FEV1 decline in current smokers but not ex-smokers with mild chronic obstructive airways disease. Am J Resp Crit Care Med 2001; 164: 358-364.
44. Patil SP, Krishnan JA, Lechtzin N, Diette GB. In-hospital mortality following acute exacerbations of chronic obstructive pulmonary disease. Arch Intern Med 2003; 163: 1180-1186.
45. Connors AF Jr, Dawson NV, Harrell FE Jr, et al. Outcomes following acute exacerbations of severe chronic obstructive airways disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment). Am J Respir Crit Care Med 1996; 154: 959-967.
46. Groenewegen KH, Schols AM, Wouters EF. Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest 2003; 124: 459-467.
47. Eriksen N, Hansen EF, Munch EP, Rasmussen FV, Vestbo J. Kronisk obstructiv lungesygdom. Indlæggelse, forløb og prognose. (Chronic obstructive pulmonary disease - admission and prognosis). Ugeskr Laeger 2003; 165: 3499-3502
48. Vestbo J, Prescott E, Lange P, Schnohr P, Jensen G. Vital prognosis after hospitalization for COPD: a study of a random population sample. Respir Med 1998; 92: 772-776.
49. Osman LM, Godden DJ, Friend JAR, Legge JS, Douglas JG. Quality of life and hospital re-admission in patients with chronic obstructive airways disease. Thorax 1997; 52: 67-71.
50. Fan VS, Curtis JR, Tu SP, McDonell MB, Fihn SD and the Ambulatory Care Quality Improvement Project Investigators. Using quality of life to predict hospitalization and mortality in patients with obstructive lung diseases. Chest 2002; 122: 429-436.
51. Jones PW, Ståhl E. Reducing exacerbations leads to a better health-related quality of life in patients with COPD. Eur Respir J 2003; 22: Suppl. 45, 238s
52. Spencer S, Jones PW and the GLOBE Study Group. Time course of recovery of health status following an infective exacerbation of chronic bronchitis. Thorax 2003; 58: 589-593.
53. Vermeire P. The burden of chronic obstructive pulmonary disease. Respir Med 2002; 96: Suppl. C, S3-S10.
54. Wouters EF. Economic analysis of the Confronting COPD survey: an overview of results. Respir Med 2003; 97: Suppl. C, S3-S14.
55. Andersson F, Borg S, Jansson SA, et al. The costs of exacerbations in chronic obstructive pulmonary disease (COPD). Respir Med 2002; 96: 700-708.
56. Miravittlles M, Murio C, Guerrero T, Gisbert R, DAFNE Study Group. Pharmacoeconomic evaluation of acute exacerbations of chronic bronchitis and COPD. Chest 2002; 121: 1449-1455.
57. Partridge MR. Living with COPD: the patients' perspective. Eur Respir Rev 2004; 88: 1-5.
58. Löfdahl C-G. Reducing the impact of COPD exacerbations: clinical efficacy of budesonide/formoterol. Eur Respir Rev 2004; 88: 14-21.
59. Nichol K, Baken L, Nelson A. Relation between influenza vaccination and outpatient visits, hospitalization, and mortality in elderly persons with chronic lung disease. Ann Intern Med 1999; 130: 397-403.
60. Godtfredsen NS, Vestbo J, Osler M, Prescott E. Risk of hospital admission for COPD following smoking cessation and reduction: a Danish Population study. Thorax 2002; 57: 967-992.
61. Adams SG, Melo J, Luther M, Anzueto A. Antibiotics are associated with lower relapse rates in outpatients with acute exacerbations of COPD. Chest 2000; 117: 1345-1352.
62. Stockley RA, O'Brien C, Pye A, Hill SL. Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD. Chest 2000; 117: 1638-1645.
63. Decramer M, Lacquet LM, Fagard R, Rogiers P. Corticosteroids contribute to muscle weakness in chronic airflow obstruction. Am J Respir Crit Care Med 1994; 150: 11-16.
64. Schols AM, Wesseling G, Kester AD, et al. Dose dependent increased mortality risk in COPD patients treated with oral glucocorticoids. Eur Respir J 2001; 17: 337-342.
65. Jones PW, Willits LR, Burge PS, Calverley PM and the Inhaled Steroids in Obstructive Lung Disease in Europe Study Investigators. Disease severity and the effect of fluticasone propionate on chronic obstructive pulmonary disease exacerbations. Eur Respir J 2003; 21: 68-73.
66. Postma DS, Kerstjens HAM. Are inhaled glucocorticoids effective in chronic obstructive pulmonary disease? Am J Respir Crit Care Med 1999; 160: S66-S71.
67. Hattotuwa KL, Gizycki MJ, Ansari TW, Jeffery PK, Barnes NC. The effects of inhaled fluâcasone fluticasone on airway inflammation in chronic obstructive pulmonary disease: a double-blind, placebo-controlled biopsy study. Am J Respir Crit Care Med 2002; 165: 1592-1596.
68. Gizycki MJ, Hattotuwa KL, Bames N, Jeffery PK. Effects of fluticasone propionate on inflammatory cells in COPD: an ultrastructural examination of endobronchial biopsy tissue. Thorax 2002; 57: 799-803.
69. Alsaeedi A, Sin DD, McAlister FA. The effects of inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review of randomized placebo-controlled trials. Am J Med 2002; 113: 59-65.
70. Sin DD, Tu JV. Inhaled corticosteroids and the risk of mortality and readmission in elderly patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 164: 580-584.
71. Soriano JB, Vestbo J, Pride NB, Kiri V, Maden C, Maier WC. Survival in COPD patients after regular use of fluticasone propionate and salmeterol in general practice. Eur Respir J 2002; 20: 819-825.
72. Soriano JB, Kiri V, Pride NB, Vestbo J. Inhaled corticosteroids with/without long acting beta agonists reduce the risk of re-hospitalisation and death in COPD patients. Am J Respir Med 2003; 2: 67-74.
73. 2-agonists in the management of stable chronic obstructive pulmonary disease. Drugs 2000; 60: 307-320.
74. Greefhorst APM, Dahl R, Nowak D, et al. Effect of inhaled formoterol and ipratropium bromide on quality of life, "bad days" and exacerbations in patients with COPD. Am J Respir Crit Care Med 2000; 161: A490.
75. Donohue JF, van Noord JA, Bateman ED, et al. A 6-month placebo-controlled study comparing lung function and health status changes in COPD patients treated with tiotropium or salmeterol. Chest 2002; 122: 47-55.
76. Friedman M, Della Cioppa G, Kottakis J. Formoterol therapy for chronic obstructive pulmonary disease: a review of the literature. Pharmacotherapy 2002; 22: 1129-1139.
77. Vincken W, van Noord JA, Greefhorst APM, et al. Improved health outcomes in patients with COPD during 1-yrs' treatment with tiotropium. Eur Respir J 2002; 19: 209-216.
78. Korn SH, Jerre A, Brattsand R. Effects of formoterol and budesonide on GM-CSF and IL-8 secretion by triggered human bronchial epithelial cells. Eur Respir J 2001; 17: 1059-1061.
79. Spoelstra FM, Postma DS, Hovenga H, Noordhock JA, Kauffman HF. Additive anti-inflammatory effect of formoterol and budesonide on human lung fibroblasts. Thorax 2002; 57: 237-241.
80. Dowling RB, Johnson M, Cole PJ, Wilson R. Effect of fluticasone propionate and salmeterol on Pseudomonas aeruginosa infection of the respiratory mucosa in vitro. Eur Respir J 1999; 14: 363-369.
81. Pauwels RA, Löfdahl CG, Postma DS, et al. Effect of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol and Corticosteroid Establishing Therapy (FACET) International Study Group. N Engl J Med 1997; 337: 1405-1411.