Predicting Re-Exacerbation Timing and Understanding Prolonged Exacerbations: An Analysis of Patients with COPD in the ECLIPSE Cohort

Wilhelmine H Meeraus,1 Hana Mullerova,1 Céline El Baou,2 Marion Fahey,1 Edith M Hessel,2 William A Fahy2 1GlaxoSmithKline plc., Epidemiology – Value, Evidence and Outcomes, Middlesex, UK; 2GlaxoSmithKline plc., Research and Development, Middlesex, UKCorrespondence: Wilhelmine H MeerausGlaxoSmithKline plc. House, 980 Great West Road, Brentford, Middlesex, TW8 9GS, UKTel +44 208 047 6757Email wilhelmine.h.meeraus@gsk.comPurpose: Understanding risk factors for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is important for optimizing patient care. We re-analyzed data from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study (NCT00292552) to identify factors predictive of re-exacerbations and associated with prolonged AECOPDs.Methods: Patients with COPD from ECLIPSE with moderate/severe AECOPDs were included. The end of the first exacerbation was the index date. Timing of re-exacerbation risk was assessed in patients with 180 days’ post-index-date follow-up data. Factors predictive of early (1– 90 days) vs late (91– 180 days) vs no re-exacerbation were identified using a multivariable partial-proportional-odds-predictive model. Explanatory logistic-regression modeling identified factors associated with prolonged AECOPDs.Results: Of the 1,554 eligible patients from ECLIPSE, 1,420 had 180 days’ follow-up data: more patients experienced early (30.9%) than late (18.7%) re-exacerbations; 50.4% had no re-exacerbation within 180 days. Lower post-bronchodilator FEV1 (P=0.0019), a higher number of moderate/severe exacerbations on/before index date (P< 0.0001), higher St. George’s Respiratory Questionnaire total score (P=0.0036), and season of index exacerbation (autumn vs winter, P=0.00164) were identified as predictors of early (vs late/none) re-exacerbation risk within 180 days. Similarly, these were all predictors of any (vs none)