@article{f25043a10d0e4e74a34c175be3f90b5c,
title = "Radiographic lung volumes predict progression to COPD in smokers with preserved spirometry in SPIROMICS",
abstract = "The characteristics that predict progression to overt chronic obstructive pulmonary disease (COPD) in smokers without spirometric airflow obstruction are not clearly defined. We conducted a post hoc analysis of 849 current and former smokers (≥20 pack-years) with preserved spirometry from the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort who had baseline computed tomography (CT) scans of lungs and serial spirometry. We examined whether CT-derived lung volumes representing air trapping could predict adverse respiratory outcomes and more rapid decline in spirometry to overt COPD using mixed-effect linear modelling. Among these subjects with normal forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio, CT-measured residual volume (RVCT) to total lung capacity (TLCCT) ratio varied widely, from 21% to 59%. Over 2.5±0.7 years of follow-up, subjects with higher RVCT/TLCCT had a greater differential rate of decline in FEV1/FVC; those in the upper RVCT/TLCCT tertile had a 0.66% (95% CI 0.06%-1.27%) faster rate of decline per year compared with those in the lower tertile (p=0.015) regardless of demographics, baseline spirometry, respiratory symptoms score, smoking status (former versus current) or smoking burden (pack-years). Accordingly, subjects with higher RVCT/TLCCT were more likely to develop spirometric COPD (OR 5.7 (95% CI 2.4-13.2) in upper versus lower RVCT/TLCCT tertile; p<0.001). Other CT indices of air trapping showed similar patterns of association with lung function decline; however, when all CT indices of air trapping, emphysema, and airway disease were included in the same model, only RVCT/TLCCT retained its significance. Increased air trapping based on radiographic lung volumes predicts accelerated spirometry decline and progression to COPD in smokers without obstruction.",
author = "{the SPIROMICS Investigators} and Mehrdad Arjomandi and Siyang Zeng and Igor Barjaktarevic and Barr, {R. Graham} and Bleecker, {Eugene R.} and Bowler, {Russell P.} and Buhr, {Russell G.} and Criner, {Gerard J.} and Comellas, {Alejandro P.} and Cooper, {Christopher B.} and Couper, {David J.} and Curtis, {Jeffrey L.} and Dransfield, {Mark T.} and Han, {Mei Lan K.} and Hansel, {Nadia N.} and Hoffman, {Eric A.} and Kaner, {Robert J.} and Kanner, {Richard E.} and Krishnan, {Jerry A.} and Robert Paine and Peters, {Stephen P.} and Rennard, {Stephen I.} and Woodruff, {Prescott G.} and Alexis, {Neil E.} and Anderson, {Wayne H.} and Bateman, {Lori A.} and Bhatt, {Surya P.} and Boucher, {Richard C.} and Christenson, {Stephanie A.} and Crystal, {Ronald G.} and Doerschuk, {Claire M.} and Brad Drummond and Freeman, {Christine M.} and Craig Galban and Hastie, {Annette T.} and Yvonne Huang and Kleerup, {Eric C.} and LaVange, {Lisa M.} and Lazarus, {Stephen C.} and Martinez, {Fernando J.} and Meyers, {Deborah A.} and Moore, {Wendy C.} and Newell, {John D.} and Laura Paulin and Cheryl Pirozzi and Nirupama Putcha and Oelsner, {Elizabeth C.} and O'Neal, {Wanda K.} and Ortega, {Victor E.} and Sanjeev Raman",
note = "Funding Information: Conflict of interest: S. Zeng reports salary support from United States Department of Veterans Affairs, during the conduct of the study. I. Barjaktarevic reports grants from AMGEN, grants and personal fees from GE Healthcare, personal fees from Grifols, AstraZeneca, CSL Behring, Boehringer Ingelheim, Verona Pharma and Fisher and Pykel Healthcare, outside the submitted work. R.G. Barr reports grants from NIH, Foundation for the NIH and COPD Foundation, during the conduct of the study; grants from Alpha1 Foundation, personal fees (royalties) from UpToDate, outside the submitted work. E.R. Bleecker reports grants from SARP, AsthmaNET, SPIROMICS, Pharmacogenetics and Foundation NIH, involvement in clinical trials administered through Wake Forest School of Medicine for Amgen, AstraZeneca/MedImmune, Boehringer Ingelheim, Genentech/Roche, GlaxoSmithKline, Janssen/Johnson & Johnson, Novartis, Pfizer, Sanofi-Regeneron and Teva, personal fees for consultancy from Amgen, AstraZeneca/MedImmune, Boehringer Ingelheim, Genentech/Roche, GlaxoSmithKline, Knopp, Novartis and Sanofi/Regeneron, outside the submitted work. R.P. Bowler reports having served on advistory boards for Boehringer-Ingelheim and Abbott Nutrition, outside the submitted work. R.G. Buhr reports personal fees from GlaxoSmithKline, outside the submitted work. G.J. Criner has nothing to disclose. A.P. Comellas reports grants from NIH, during the conduct of the study; non-financial support for consultancy from VIDA Diagnostics, outside the submitted work. C.B. Cooper has nothing to disclose. D.J. Couper reports grants from NHLBI (NIH) and COPD Foundation, during the conduct of the study; grants from NHLBI (NIH), outside the submitted work. J.L. Curtis reports grants from NIH/NHLBI (U01HL137880), during the conduct of the study; and grants from Department of Veterans Affairs (I01 CX000911), NIH/NIAID (R01 AI120526, R21 AI 117371), Department of Defense (W81XWH-15-1-0705, PR150432) and MedImmune, Corp. Ltd, outside the submitted work. M.T. Dransfield reports grants from NIH, during the conduct of the study; grants from Department of Defense, NIH and the American Lung Association, personal fees for consultancy and involvement with contracted clinical trials for Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, PneumRx/BTG and Boston Scientific, involvement with contracted clinical trials for Novartis, Yungjin and Pulmonx, personal fees for consultancy from Genentech, Quark Pharmaceuticals and Mereo, outside the submitted work. M.K. Han reports personal fees from GSK, BI and AZ, non-financial support from Novartis and Sunovion, outside the submitted work. N.N. Hansel reports grants and personal fees for consultancy from AstraZeneca and GSK, grants from Boehringer Ingelheim, NIH and COPD Foundation, personal fees for consultancy from Mylan, outside the submitted work. E.A. Hoffman reports grants from NIH, during the conduct of the study; and is a founder and shareholder of VIDA Diagnostics, a company commercialising lung image analysis software developed, in part, at the University of Iowa. R.J. Kaner reports personal fees from Boehringer Ingelheim, Roche/Genentech, Medimmune/AstraZeneca, Gilead, Celgene and Janssen, outside the submitted work. R.E. Kanner has nothing to disclose. J.A. Krishnan has nothing to disclose. R. Paine III reports grants from NHLBI and COPD Foundation, during the conduct of the study; grants from Department of Veterans Affairs, outside the submitted work. S.P. Peters, reports grants from NIH, NHLBI as the PI of the Wake Forest Clinical Site for the SPIROMICS COPD Program, during the conduct of the study. S.I. Rennard is employed by AstraZeneca, Cambridge, UK and also retains Professorship and a part-time appointment at the the University of Nebraska Medical Center, Omaha, NE, USA. P.G. Woodruff reports personal fees for consultancy from Theravance, AstraZeneca, Regeneron, Sanofi, Genentech, Roche and Janssen, outside the submitted work. M. Arjomandi reports salary support from United States Department of Veterans Affairs, grants and salary support from United States National Institute of Health, during the conduct of the study. Funding Information: Support statement: SPIROMICS was supported by contracts from the NIH/NHLBI (HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, HHSN268200900020C), and supplemented by contributions made through the Foundation for the NIH and the COPD Foundation from AstraZeneca/MedImmune, Bayer, Bellerophon Therapeutics; Boehringer Ingelheim Pharmaceuticals, Inc., Chiesi Farmaceutici S.p.A., Forest Research Institute, Inc., GlaxoSmithKline, Grifols Therapeutics, Inc., Ikaria, Inc., Novartis Pharmaceuticals Corporation, Nycomed GmbH, ProterixBio, Regeneron Pharmaceuticals, Inc., Sanofi, Sunovion, Takeda Pharmaceutical Company and Theravance Biopharma. Funding for the work on this manuscript was also provided by the Flight Attendant Medical Research Institute (M. Arjomandi). Funding information for this article has been deposited with the Crossref Funder Registry. Publisher Copyright: Copyright {\textcopyright} ERS 2019",
year = "2019",
month = oct,
day = "1",
doi = "10.1183/13993003.02214-2018",
language = "English (US)",
volume = "54",
journal = "European Respiratory Journal",
issn = "0903-1936",
publisher = "European Respiratory Society",
number = "4",
}