Rescue medication use as a patient-reported outcome in COPD: a systematic review and regression analysis

• Published in: Respiratory research 2017-05, Vol.18 (1), p.86-86, Article 86
• Main Authors: Punekar, Yogesh Suresh, Sharma, Sheetal, Pahwa, Ankit, Takyar, Jitender, Naya, Ian, Jones, Paul W
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Adult; Asthma; Bias; Biomarkers; Bronchodilator Agents - therapeutic use; Bronchodilators; Chronic obstructive pulmonary disease; Citations; Clinical trials; COPD; Correlation analysis; Correlation coefficient; Correlation coefficients; Disease prevention; Drugs; Dyspnea; Female; Humans; Inhaled corticosteroid; Long-acting muscarinic antagonist; Long-acting β2-agonist; Lung diseases; Lung function outcomes; Male; Middle Aged; Obstructive lung disease; Patient Reported Outcome Measures; Patients; Prevalence; Proportional Hazards Models; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - epidemiology; Questionnaires; Regression Analysis; Reproducibility of Results; Rescue medication use; Respiration; Risk Factors; Self Report; Sensitivity and Specificity; Studies; Treatment Outcome; Utilization Review
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-017-0566-1

Reducing rescue medication use is a guideline-defined goal of asthma treatment, however, little is known about the validity of rescue medicine use as a marker of symptoms in chronic obstructive pulmonary disease (COPD). To improve patient outcomes, greater insight is needed into the relationship between rescue medication use and alternative COPD outcomes. A systematic search of electronic databases (Embase®, MEDLINE® and Cochrane CENTRAL) was conducted from database start to 26 May, 2015. Studies of bronchodilator therapy with a duration of ≥24 weeks were included if they reported either mean change from baseline (CFB) in rescue medication use in puffs/day or % rescue-free days (%RFD), and at least one other COPD endpoint. Correlation and meta-regression analyses were undertaken to test the association between rescue medication use and other COPD outcomes using weighted means (weights proportional to the sample size of the treatment group) and unweighted means (equal weight for each treatment group). Each association was assessed at 6 months and study end. Forty-six studies involving 46,531 patients provided mean data from 145 treatment groups for evaluation. Changes in both measures of rescue medication use were correlated with changes in trough forced expiratory volume in one second ([FEV ]; Pearson correlation coefficients |r| ≥ 0.63; p