Characterisation of COPD heterogeneity in the ECLIPSE cohort
Open accessAbstract
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a complex condition with pulmonary and extra-pulmonary manifestations. This study describes the heterogeneity of COPD in a large and well characterised and controlled COPD cohort (ECLIPSE). METHODS: We studied 2164 clinically stable COPD patients, 337 smokers with normal lung function and 245 never smokers. In these individuals, we measured clinical parameters, nutritional status, spirometry, exercise tolerance, and amount of emphysema by computed tomography. RESULTS: COPD patients were slightly older than controls and had more pack years of smoking than smokers with normal lung function. Co-morbidities were more prevalent in COPD patients than in controls, and occurred to the same extent irrespective of the GOLD stage. The severity of airflow limitation in COPD patients was poorly related to the degree of breathlessness, health status, presence of co-morbidity, exercise capacity and number of exacerbations reported in the year before the study. The distribution of these variables within each GOLD stage was wide. Even in subjects with severe airflow obstruction, a substantial proportion did not report symptoms, exacerbations or exercise limitation. The amount of emphysema increased with GOLD severity. The prevalence of bronchiectasis was low (4%) but also increased with GOLD stage. Some gender differences were also identified. CONCLUSIONS: The clinical manifestations of COPD are highly variable and the degree of airflow limitation does not capture the heterogeneity of the disease.
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Breathlessness severity is not reliably predicted by the severity of airflow limitation/lung pathology in COPD.
“Its intensity is not reliably predicted by the severity of lung pathology”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [7]
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Self-citationPrevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013
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The chronic bronchitis phenotype in subjects with and without COPD: the PLATINO study
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Self-citationPrevalence of depression in COPD: A systematic review and meta-analysis of controlled studies
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Disturbed Intestinal Integrity in Patients With COPD
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Self-citationThe Prevalence of Metabolic Syndrome In Chronic Obstructive Pulmonary Disease: A Systematic Review
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Extrapulmonary comorbidities in chronic obstructive pulmonary disease: state of the art
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Beyond FEV1 in COPD: a review of patient-reported outcomes and their measurement
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Cytokine inhibition in the treatment of COPD
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Self-citationWomen and COPD: do we need more evidence?
Gut‐Gobert, C., Cavailles, A., Dixmier, A., Guillot, S., Jouneau, S., Leroyer, C., Marchand-Adam, S., Marquette, D., Meurice, J.-C., Desvigne, N., et al. (2019) · European Respiratory Review · doi:10.1183/16000617.0055-2018 · Cited by 163 · see citing works
Self-management interventions for people with chronic obstructive pulmonary disease
Schrijver, J., Lenferink, A., Brusse-Keizer, M., Zwerink, M., van der Valk, P. D., van der Palen, J. A. M., & Effing, T. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002990.pub4 · Cited by 170 · see citing works
Bronchiectasis in COPD patients: more than a comorbidity?
Martínez‐García, M. Á., & Miravitlles, M. (2017) · International Journal of COPD · doi:10.2147/copd.s132961 · Cited by 162 · see citing works
Vogelmeier, C. F., Buhl, R., Burghuber, O. C., Criée, C.-P., Ewig, S., Godnić‐Cvar, J., Hartl, S., Herth, F. J. F., Kardos, P., Kenn, K., et al. (2018) · Pneumologie · doi:10.1055/s-0043-125031 · Cited by 177 · see citing works
COPD 2020: changes and challenges
Agustí, A. G. N., Vogelmeier, C. F., & Faner, R. (2020) · American Journal of Physiology-Lung Cellular and Molecular Physiology · doi:10.1152/ajplung.00429.2020 · Cited by 157 · see citing works
Metabolic profiling detects biomarkers of protein degradation in COPD patients
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Self-citationRennard, S. I., Locantore, N., Delafont, B., Tal‐Singer, R., Silverman, E. K., Vestbo, J., Miller, B. E., Bakke, P. S., Celli, B. R., Calverley, P. M. A., et al. (2015) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201403-125oc · Cited by 154 · see citing works
Self-citationNetwork Analysis of Lung Transcriptomics Reveals a Distinct B-Cell Signature in Emphysema
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Self-citationBronchial epithelium as a target for innovative treatments in asthma
Gras, D., Chanez, P., Vachier, I., Petit, A., & BOURDIN, A. A. (2013) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2013.07.008 · Cited by 141 · see citing works
Club Cell Protein 16 and Disease Progression in Chronic Obstructive Pulmonary Disease
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Self-citationThe Acute COPD Exacerbation Prediction Tool (ACCEPT): a modelling study
Adibi, A., Sin, D. D., Safari, A., JOHNSON, K., Aaron, S. D., FitzGerald, J. M., & Sadatsafavi, M. (2020) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(19)30397-2 · Cited by 138 · see citing works
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Quantifying the Extent of Emphysema:
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Self-citationCOPD: early diagnosis and treatment to slow disease progression
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Quantitative Computed Tomography in COPD: Possibilities and Limitations
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Comorbidities in patients with COPD and pulmonary rehabilitation: do they matter?
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Self-citationImpact of comorbidities on COPD-specific health-related quality of life
Burgel, P., Escamilla, R., Perez, T., Carré, P., Caillaud, D. M., Chanez, P., Pinet, C., Jébrak, G., Brinchault, G., Court‐Fortune, I., et al. (2012) · Respiratory Medicine · doi:10.1016/j.rmed.2012.10.002 · Cited by 128 · see citing works
Diagnosis, assessment, and phenotyping of COPD: beyond FEV1
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Self-citationEchocardiographic abnormalities in patients with COPD at their first hospital admission
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B cells in chronic obstructive pulmonary disease: moving to center stage
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COPD-related Bronchiectasis; Independent Impact on Disease Course and Outcomes
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Self-citation
- Authors
- the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) investigators, Agusti, A., Calverley, P. M., Celli, B., Coxson, H. O., Edwards, L. D., Lomas, D. A., MacNee, W., Miller, B. E., Rennard, S., Silverman, E. K., Tal-Singer, R., Wouters, E., Yates, J. C., & Vestbo, J.
- Affiliations
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES)
- Brigham and Women's Hospital (US)
- University of British Columbia (CA)
- University of Cambridge (GB)
- Edinburgh Royal Infirmary (GB)
- GlaxoSmithKline (United States) (US)
- Maastricht University Medical Centre (NL)
- University of Copenhagen (DK)
- ORCID
- Venue
- Respiratory Research
- Published
- 2010-09-10
- Volume
- 11
- Issue
- 1
- Pages
- 122-122
- ISSN
- 1465-9921 (ISSN-L)
- 1465-993X
- PMC
- PMC2944278
- OpenAlex
- W2142096203
- Semantic Scholar
- 40fa41938c0c969c1ab6219b857fcd884f7a804b
- Cited by
- 1,157
- References
- 32
- Citations by year
- 2026: 24 · 2025: 32 · 2024: 51 · 2023: 39 · 2022: 50 · 2021: 83 · 2020: 91 · 2019: 73 · 2018: 94 · 2017: 101 · 2016: 96 · 2015: 103 · 2014: 104 · 2013: 90 · 2012: 67
- FWCI
- 57.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Respiratory Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion, cc-by)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion, other-oa)
- DigitalCommons@UNMC (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- GlaxoSmithKline
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- chronic obstructive pulmonary disease, disease heterogeneity, ECLIPSE cohort, GOLD severity, airflow obstruction, dyspnea, comorbidities, exacerbations, exercise capacity, emphysema, bronchiectasis, nutritional status, smoking, never smokers, sex differences
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Female, Humans, Longitudinal Studies, Male, Middle Aged, Respiratory Function Tests, Smoking, Cohort Studies, Pulmonary Disease, Chronic Obstructive
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