September 24, 2022

Taylor Daily Press

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The frequency of exacerbations in COPD trials varies between countries

The frequency of exacerbations in COPD trials varies between countries

The frequency of exacerbations appears to differ between countries that contributed to clinical trials with COPD patients. This emerged from a systematic analysis of three clinical trials conducted in blue magazine figured out.

Exacerbations are an important end point in international clinical trials of COPD patients. The number of observed exacerbations is often less than expected and appears to vary from country to country. This analysis reviewed data from 3 large international randomized trials conducted over an 18-year period. Study design and disease severity differed for the participating patients and the studies aimed to compare the use of bronchodilators and/or inhaled corticosteroids and bronchodilators alone and/or placebo.

For nearly 30,000 patients in the 41 countries analyzed, the average frequency of pulmonary attacks was two to three times different between the highest and lowest levels in the recruiting countries. These differences cannot be explained by demographics, study protocol, or previous exacerbations. Of the eighteen countries that contributed to all studies, half of the countries remained at the highest or lowest levels of exacerbations in all trials in these triad regions. Severe lung attacks had a different order internationally.

These differences help explain why large studies are needed to show differences between treatments that reduce the risk of lung attacks.


Calverley PM, Martinez FJ, Vestbo J, et al. International differences in the frequency of COPD exacerbations reported in three clinical trials. Am J Respir Crit Care Med. 2022; 206: 25-33.