Reduced COPD exacerbation risk correlates with improved FEV 1 : A meta-regression analysis

Background

The mechanism by which various classes of medication reduce COPD exacerbation risk remains unknown. We hypothesized a correlation between reduced exacerbation risk and improvement in airway patency as measured by the forced expiratory volume in 1 second (FEV1).

Methods

By systematic review, we identified COPD trials that reported therapeutic changes in pre-dose FEV1 (dFEV1) and occurrence of moderate to severe exacerbations. Using meta-regression analysis, we generated a model with dFEV1 as moderator variable, and absolute difference in exacerbation rate (RD), ratio of exacerbation rates (RR), or hazard ratio (HR) as dependent variables.

Results

The analysis of RD and RR included 119,227 patients, and that of HR 73,475 patients. For every 100 mL change in pre-dose FEV1, the HR decreased by 21% (95% CI: 17-26%, PConclusions

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