TY - JOUR T1 - The “susceptibility to exacerbation” phenotype in COPD and response to pulmonary rehabilitation JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p1250 AU - J.L. Canavan AU - K.A. Ingram AU - R.P. Fowler AU - P. Marns AU - K. Dobson AU - A.L. Clark AU - C.M. Nolan AU - M.I. Polkey AU - W.D.-C. Man Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p1250.abstract N2 - Introduction: Exacerbations are a key feature of COPD and are known to impact lung function, daily physical activity level, quality of life, survival, and health resource usage. Pulmonary rehabilitation (PR) is an effective treatment for disability in COPD, with previous research identifying improved outcome for patients reporting no exacerbations (NE) when compared with patients suffering exacerbations (Riario-Sforza et al., 2005). A frequent susceptibility exacerbation phenotype (≥2 exacerbations in previous year) has been identified (Hurst et al., 2010) which may have implications for response to PR. We hypothesised that patients with frequent exacerbations (FE) would gain less benefit from an 8-week outpatient PR program.Method: In 93 COPD patients reporting NE (n=28), one exacerbation (OE) (n=28) or FE (n =37) in the previous year, the following assessments were made before (T0) and after (T1) PR: fat free mass (FFM), incremental shuttle walk (ISW), self-report Chronic Respiratory Disease Questionnaire (CRDQ-SR).Median (IQR) change in ISW, FFM, and CRDQ-SR total score from T0 to T1 was compared between groups using Kruskal-Wallis tests.Results: ISW distance and CRDQ-SR increased in NE (80 (13-148)m, 13.5 (1.5-23.8)) OE (50 (0-110)m, 19.0 (2.0-32.0)) and FE (60 (20-270)m, 21.0 (8.0-28.0)) groups.FFM increased in NE (0.36 (-1.32-1.26)kg) and OE (0.51 (-0.85-1.33)kg) but not FE (-0.07 (-1.38-2.29)kg).No significant differences were found between groups for any variables (ISW: p = 0.46, CRDQ total p = 0.35, FFM: p = 0.94).Conclusion: The “susceptibility to exacerbation” phenotype does not appear to affect improvements in exercise capacity, or health related quality of life gained during PR. ER -