Endocrine Abstracts

Introduction: Metabolic disorder has been frequently observed in chronic obstructive pulmonary disease (COPD) patients. In particular, metabolic comorbidities exert a major impact on patients’ morbidity and mortality. Diabetes mellitus, dyslipidemia and osteoporosis are among the most commonly reported metabolic comorbidities in patients with chronic lung disease. COPD patients with comorbidities, such as metabolic disease, are generally more dyspnoeic and have worse health status in comparison to patients without comorbidities.

Objectives: We evaluated FEV1 (%predicted) change and MRC dyspnea score in COPD patients with at least one metabolic comorbidity versus the patients without any comorbidity, treated with a fluticasone–salmeterol fixed dose combination (FDC) for 12 months.

Methods: Prospective, multicenter, non-interventional clinical study (NCT02978703) in which 1016 patients, aged 69.54 ± 9.57 with a mean body mass index of 28.65 ± 5.38, were evaluated and of whom 378 (37.2%) had at least one metabolic disease and 238 (23.4%) hadn’t any comorbidity. Pulmonary function was assessed by FEV1 (%predicted) changes and MRC dyspnea scores among visits. The corresponding data were collected at 6 (V1) and 12 (V2) months, respectively.

Results: In the study population without any comorbidity there was a significant improvement (P<0.0001) in both FEV1 (%predicted) between baseline (V0) and final (V2) visit, as well as between consecutive visits (V0: Mean ± S.D.: 49.90 ± 8.23, V1: Mean ± S.D.: 55.95 ± 10.96, V2: Mean ± S.D.: 59.16 ± 11.84). Similar significant improvement was observed on the MRC dyspnea scale (P < 0.0001, Kruskal–Wallis test). In COPD patients with at least one metabolic comorbidity, a corresponding but reduced improvement was observed in FEV1 (%predicted), between baseline and final visit, and between visits [FEV1%predicted: (V0: Mean ± S.D.: 47.99 ± 8.85, V1: Mean ± S.D.: 54.17 ± 11.43, V2: Mean ± S.D.: 56.02 ± 12.12), and on the MRC dyspnea scale (P < 0.0001, Kruskal–Wallis test) as well.

Conclusions: Patients with metabolic comorbidities and COPD, although they had initially slightly worse pulmonary function and MRC dyspnea score, showed a statistically significant improvement but decreased in relation to COPD patients without comorbidities, after twelve months of fluticasone–salmeterol FDC treatment.