Abstract
Background: Gastroesophageal reflux disease (GERD) is common in COPD patients but there is little prospective data on the impact of GERD on COPD exacerbations.
Objectives: To evaluate the association of GERD and GERD-related therapy with disease severity and exacerbation frequency in COPD patients.
Methods: 1087 COPD patients and 392 controls were included. GERD symptoms were evaluated with GERD-Q questionnaire and treatment with proton pump inhibitors (PPIs) was recorded. All patients were contacted monthly and acute exacerbations of COPD (AECOPD) and hospitalizations for COPD exacerbations were recorded.
Results: The presence of significant GERD symptoms was more common in COPD patients compared to controls (25.4 vs. 9.0%, p<0.001) and was associated with more severe disease. Frequency of AECOPD and hospitalizations in 1 year was associated with GERD score (r=0.703, p<0.001 and r=0.723, p<0.001, respectively). COPD patients with GERD symptoms experienced more AECOPD and hospitalizations compared to patients without GERD symptoms (4.18±1.66 vs. 0.99±0.96, p<0.001 and 2.63 ±1.63 vs. 0.36±0.59, p<0.001, respectively). COPD patients receiving PPIs experienced less AECOPD and hospitalizations than COPD patients who did not receive PPIs, both in the presence of GERD symptoms (1.60±0.69 vs. 4.27±1.60 AECOPD, p<0.001 and 0.90±0.56 vs. 2.69±1.61 hospitalizations, p<0.001) and in the absence of GERD symptoms (0.88±0.79 vs. 1.25±1.22 AECOPD, p<0.001, and 0.28±0.47 vs. 0.52±0.75 hospitalizations, p<0.001).
Conclusions: GERD symptoms are significantly associated with COPD exacerbations and hospitalizations and treatment with PPIs is related to less exacerbations and hospitalizations.
- © 2012 ERS
