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A3132 - Stability in Inflammatory Biomarkers and Functional Performance in Stable COPD
Author Block: N. Saiphoklang1, R. Marzan-McGill2, M. Villareal2, M. Dembek2, B. Dolezal3, R. Buhr2, N. Hsu2, M. Flynn2, J. Belperio2, C. Cooper2, I. Barjaktarevic2; 1Medicine, Thammasat University, Pathumthani, Thailand, 2Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States, 3Physiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States.
Rationale: Reduced functional performance and impaired health status in chronic obstructive pulmonary disease (COPD) are associated with increase in exacerbation rate and mortality. Increased evidence suggests that inflammatory biomarkers may reflect systemic effects leading to those impairments. Nevertheless, the ability of functional performance and health status testing tools to reflect alterations in inflammatory background of a patient with COPD is unclear. Objectives: To explore changing in inflammatory biomarkers and functional performance in stable COPD patients Methods: We analysed data from an ongoing observational study of stable moderate/severe COPD patients without recent exacerbation history. The data was collected at the beginning and end of a 3 month follow-up period for each participating patient. Demographics, clinical characteristics and comorbidities, laboratory studies and spirometry were recorded. Functional performance was assessed in terms of 6-minute walking distance (6MWD), Veteran's Specific Activity Questionnaire (VSAQ), handgrip strength (HGS), and modified MRC dyspnea scale (mMRC). Health status was evaluated by COPD Assessment Test (CAT), St. George's Respiratory Questionnaire for COPD (SGRQ-C), and SF12 Health Survey. Biomarkers measured were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, and white blood count (WBC) with neutrophil and eosinophil count assessment. Results: Thirty-one subjects (men 81%) were included. Mean age was 71.8±5.3 years and average BMI was 27.0±0.9 kg/m2. Enrolled patients were on average moderately obstructed with FEV1 61.0±22.2%, had smoking history of 47.8±28.0 pack-years, exacerbation history 35.5%, and comorbidities including cardiovascular disease (51.6%), asthma (22.6%), and cancer (22.6%). Current medications included LABA/ICS 35.5%, LAMA 38.7%, LABA/LAMA 9.7%, PDE4i 9.7%, and LABA 3.2%. Three-month interval repeat of the assessment of functional performance and health status showed no significant changes in 6MWD, VSAQ, HGS, mMRC, and SGRQ-C. Reevaluation of ESR, CRP, fibrinogen and WBC in both blood and sputum also showed stable measurements at the three-month interval. However, CAT score and SF12 score were the only parameters which significantly changed between the two visits (-1.8, P=0.047 for CAT and +5.5, P=0.047 for SF12) despite other parameters suggestive of stable disease. Conclusions: In patients with clinically stable COPD, the inflammatory biomarkers values were not elevated. However, variations in health status assessed by CAT and SF12 may not reflect well the changes in inflammatory biomarkers and should be taken with caution when assessing COPD stability.