Background: Acute exacerbations have a significant and permanent impact on lung function and quality of life (QoL) in patients with COPD. Previous studies focused on lung function in COPD; studies exploring the impact of exacerbations in patients with severe COPD are needed. Objective: This post-hoc meta-analysis explored the impact of exacerbations on lung function and QoL using data from two phase 3 mepolizumab RCTs in severe COPD patients with an eosinophilic phenotype and receiving inhaled glucocorticoid-based triple therapy. Methods: Pre-bronchodilator FEV1, Saint George’s Respiratory Questionnaire (SGRQ), and Euroqol-5D (EQ-5D) measures were analysed using a random intercept-slope model with a time-varying covariate for exacerbations experienced during the trials. The impact of exacerbations was estimated per moderate (requiring systemic glucocorticoid and/or antibiotic treatment) and severe exacerbation (leading to hospitalization or death) event. Results: COPD exacerbations were associated with a statistically significant worsening in SGRQ score and EQ-5D utility index, with higher impact associated with severe exacerbations (Figure 1). Moderate and severe exacerbations had a similar impact on FEV1. Conclusions: Moderate and severe exacerbations have significant impact on QoL in severe COPD patients. In patients with more severe COPD, exacerbations are a strong indicator of worsening in disease status and QoL. Funding: GSK [HO-17-18342]
