Characteristics Associated with Lung Function Trajectories: An Analysis of the SPIROMICS Cohort

<b>Rationale:</b> Discovering the biological basis of progression in chronic obstructive pulmonary disease (COPD), especially of rapid decline (RD) in forced expiratory volume in 1 second, is essential to the development of precision therapies. <b>Objectives:</b> First, we sought to define baseline characteristics of RD (⩾100 ml/yr), relative to participants with stable-to-improved (S/I) status or with intermediate decline (D)-categories based on spirometric data from the Framingham Offspring cohort. Second, we sought to examine these categories as predictors of longitudinal COPD outcomes, adjusting for baseline characteristics. <b>Methods:</b> Among ever-smoking participants in the Subpopulations and Intermediate Outcomes in COPD Study (or, SPIROMICS) with two or more spirometric measurements over 8 years, we used linear regression to fit slopes of postbronchodilator change in forced expiratory volume in 1 second. We used ordinal regression, testing baseline characteristics as predictors of lung function change categories (S/I, D, and RD) and used those categories to assess associated clinical outcomes. <b>Results:</b> In this heavy-smoking cohort (⩾20 pack-years), the status of 747 participants was S/I (40%), and that of 336 participants was RD (18%). In adjusted models of baseline factors associated with trajectories of decline, steeper decline was associated with better initial lung function (all <i>P</i> < 0.001) and greater likelihood of baseline bronchodilator responsiveness (S/I, D, and RD: 32%, 37%, and 43%, respectively; <i>P</i> < 0.001); there was no association between RD and race, ethnicity, socioeconomic status, medical history, or respiratory medication use. Regarding clinical endpoints, RD was associated with greater symptom burden, worse health-related quality of life, and increased mortality, but not exacerbation frequency. <b>Conclusions:</b> Categorical definitions of S/I and RD highlight bronchodilator responsiveness and smoking as risks for adverse outcomes, including death. Contrasting these disease trajectories will support the future identification of the biological bases of COPD progression.

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Publication Details

Journal
Annals of the American Thoracic Society
Published
2025-04-08
DOI
https://doi.org/10.1513/annalsats.202405-500oc
Citations
1
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
Type
article
Field-Weighted Citation Impact
1.52
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article

Characteristics Associated with Lung Function Trajectories: An Analysis of the SPIROMICS Cohort

Nadia N. Hansel, Lori A. Bateman, Jill Ohar, Igor Barjaktarević et al.
1 citations
Annals of the American Thoracic Society
Chronic Obstructive Pulmonary Disease (COPD) Research
1.52
article

Characteristics Associated with Lung Function Trajectories: An Analysis of the SPIROMICS Cohort

Nadia N. Hansel, Lori A. Bateman, Jill Ohar, Igor Barjaktarević, Brett A. Dolezal, Anand Iyer, MeiLan K. Han, Nicholas J. Jackson, Wayne H. Anderson, Benjamin M. Smith, Surya Prakash Bhatt, Jeffrey L. Curtis, Jane C. Fazio, Russell G. Buhr, Donald P. Tashkin, Jerry A. Krishnan, Prescott G. Woodruff, Stephen I. Rennard, Michael Drummond, David Couper, Fernando J. Martínez, Robert Paine, Christopher B. Cooper
article en
1 citations

Abstract

<b>Rationale:</b> Discovering the biological basis of progression in chronic obstructive pulmonary disease (COPD), especially of rapid decline (RD) in forced expiratory volume in 1 second, is essential to the development of precision therapies. <b>Objectives:</b> First, we sought to define baseline characteristics of RD (⩾100 ml/yr), relative to participants with stable-to-improved (S/I) status or with intermediate decline (D)-categories based on spirometric data from the Framingham Offspring cohort. Second, we sought to examine these categories as predictors of longitudinal COPD outcomes, adjusting for baseline characteristics. <b>Methods:</b> Among ever-smoking participants in the Subpopulations and Intermediate Outcomes in COPD Study (or, SPIROMICS) with two or more spirometric measurements over 8 years, we used linear regression to fit slopes of postbronchodilator change in forced expiratory volume in 1 second. We used ordinal regression, testing baseline characteristics as predictors of lung function change categories (S/I, D, and RD) and used those categories to assess associated clinical outcomes. <b>Results:</b> In this heavy-smoking cohort (⩾20 pack-years), the status of 747 participants was S/I (40%), and that of 336 participants was RD (18%). In adjusted models of baseline factors associated with trajectories of decline, steeper decline was associated with better initial lung function (all <i>P</i> < 0.001) and greater likelihood of baseline bronchodilator responsiveness (S/I, D, and RD: 32%, 37%, and 43%, respectively; <i>P</i> < 0.001); there was no association between RD and race, ethnicity, socioeconomic status, medical history, or respiratory medication use. Regarding clinical endpoints, RD was associated with greater symptom burden, worse health-related quality of life, and increased mortality, but not exacerbation frequency. <b>Conclusions:</b> Categorical definitions of S/I and RD highlight bronchodilator responsiveness and smoking as risks for adverse outcomes, including death. Contrasting these disease trajectories will support the future identification of the biological bases of COPD progression.

Annals of the American Thoracic SocietyVol. 22(8)
University of North Carolina at Chapel Hill (US), University of Nebraska at Omaha (US), Boston Medical Center (US), Johns Hopkins University (US), University of California, Los Angeles (US), University of California, San Francisco (US), Cornell University (US), University of Utah (US), University of Michigan (US), Columbia University Irving Medical Center (US), Johns Hopkins Medicine (US), McGill University Health Centre (CA), University of California System (US), University of Alabama at Birmingham (US), University of Illinois Chicago (US), The Coordinating Center (US), VA Ann Arbor Healthcare System (US), Michigan United (US), Michigan Medicine (US), Birmingham VA Medical Center (US), Pulmonary and Allergy Associates (US), Center for the Study of Healthcare Provider Behavior (US), VA Greater Los Angeles Healthcare System (US), Pulmonary and Critical Care Associates (US), Wake Forest University (US), University of Nebraska Medical Center (US), Columbia University (US)
Openalex Percentile: Top 20%
Chronic Obstructive Pulmonary Disease (COPD) Research
1.52
DOISourceOpenAlex
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