CHARACTERISTICS, STABILITY AND OUTCOMES OF THE GOLD 2011 COPD GROUPS IN THE ECLIPSE COHORT

The 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifies patients with COPD into four groups (A to D). We explored the characteristics, stability and relationship to outcomes of these groups within the ECLIPSE study (n=2101). Main results showed that: (1) these groups differed in several clinical, functional, imaging and biological characteristics in addition to those used for their own definition; (2) A and D groups were relatively stable over time, whereas groups B and C showed more temporal variability; (3) the risk of exacerbation over 3 years increased progressively from A to D, whereas that of hospitalization and mortality were lowest in A, highest in D and intermediate and similar in B and C, despite the former having milder airflow limitation. The prevalence of comorbidities and persistent systemic inflammation were highest in group B. The different longitudinal behaviour of group A vs. B and C vs. D (each pair with similar FEV1 values) supports the GOLD 2011 proposal of assessing COPD patients by more than FEV1 only. However the assumption that symptoms does not equate to risk appears to be naïve, as groups B and C carry equally poor clinical outcomes, though for different reasons. Abstract word count: 197 wordsword count: 197 words

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