Association of respiratory symptom profiles with future exacerbations and lung function decline in mild-to-moderate COPD
Year: 2025
Type: article
Abstract: Background The prognostic value of respiratory symptom profiles for predicting exacerbation risk and lung function decline remains unclear in mild-to-moderate chronic obstructive pulmonary disease (COPD). Research question Are respiratory symptom profiles associated with both exacerbation risk and lung function decline in mild-to-moderate COPD? Study design and methods This was a posthoc analysis of data from participants with mild-to-moderate COPD from the SubPopulations and InteRmediate Outcome Measures in COPD Study. Respiratory symptom profiles were identified through latent class analysis. Outcomes included exacerbation rates evaluated by zero-inflated negative binomial regressions, time-to-first exacerbation evaluated by Cox regression and longitudinal forced expiratory volume in 1 second (FEV 1 ) decline evaluated by linear mixed-effects models. Results Among the 954 participants with mild-to-moderate COPD, five distinct respiratory symptom profiles were identified. Compared with the ‘minimal respiratory’ profile, the ‘productive cough’ profile was associated with a higher rate of any respiratory exacerbations (relative ratio [RR] 1.84; 95% confidence interval [CI] 1.29 to 2.64) and severe respiratory exacerbations (RR 2.05; 95% CI 1.12 to 3.74). Similarly, the ‘Wheeze’ profile was associated with higher rates of any (RR 1.55; 95% CI 1.12 to 2.15) and severe exacerbations (RR 1.73; 95% CI 1.00 to 2.98). The ‘nearly all respiratory symptoms’ profile was associated with a higher rate of exacerbations (any exacerbation: RR 2.12; 95% CI 1.56 to 2.89; severe exacerbations: RR 2.07; 1.23 to 3.47) and an accelerated annual FEV 1 decline (−15.41 mL/year; 95% CI −30.33 to −0.51 mL/year). The ‘dry cough’ profile exhibited the lowest FEV 1 trajectory despite a non-significant annual decline. Interpretation Respiratory symptom profiles identifies distinct prognostic outcomes in mild-to-moderate COPD. The productive cough is associated with increased exacerbation risk, while the dry cough is associated with a lower lung function trajectory. Trial registration number NCT0196934 .
Source: BMJ Open Respiratory Research
Authors: Huajing Yang, Shiying Fang, Yuqiong Yang, Gengjia Chen, Shanshan Zha, Chengyu Miao, Zizheng Chen, Xueping Li, Zifei Zhou, Wenqiang He, Youhai Yu, Fangcheng Liu, Yuling Wu, Fengyan Wang, M Bradley Drummond, Nanshan Zhong, Rongchang Chen, Zhenyu Liang
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,085
Funders: Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Natural Science Foundation of China, Ministry of Science and Technology of the People's Republic of China, China Postdoctoral Science Foundation, China International Medical Foundation, Guangzhou Municipal Science and Technology Project, National Key Research and Development Program of China, Shenzhen Science and Technology Innovation Program
OpenAlex ID: W4416934843