RT Journal Article
SR Electronic
T1 Validation of the codex index in patients with COPD enrolled in randomized clinical trials: A post-hoc analysis of the trilogy, trinity and tribute studies
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3761
DO 10.1183/13993003.congress-2020.3761
VO 56
IS suppl 64
A1 Pere Almagro
A1 Paola Vaghi
A1 Silva Tommasini
A1 Diego González-Segura
A1 Eva Topole
A1 George Georges
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/3761.abstract
AB Introduction: The CODEX (age-adjusted Charlson comorbidity score, Obstruction, Dyspnea, and severe EXacerbations) index has shown to be useful at predicting survival and COPD readmissions, with a prognostic capacity superior to other indices. Its validation in randomized clinical trials has not been performed.Aims and Objectives: To explore the performance of the CODEX in a cohort from pooled multinational randomized pharmacological intervention clinical trials, in comparison to the BODEX, DOSE and ADO indices.Methods: TRILOGY, TRINITY, and TRIBUTE were phase III randomized clinical trials that evaluated 1-yr treatment with extra fine BDP/FF/GB versus other maintenance therapies in symptomatic patients with severe COPD and a history of exacerbations. Patients from the intent-to-treat population of each study were considered, those with missing data for any of the variables involved in the derivation of the COPD multivariate indices were excluded.Results: 5588 patients were considered, 5584 entered the analysis. 565 (10.1%) of patients experienced death or a severe exacerbation. The mean (SD) CODEX index was 5.7 (1.15), with 82.6% of patients scoring between 5-9 on a 0-10 scale. For patients with a score ≥5, the Hazard Ratio (HR) for either death or a severe exacerbation was 2.6 (95%CI: 1.9 – 3.5, p<0.0001). ROC curves indicated a predictive capacity for the CODEX that was higher than the ADO and DOSE and similar to the BODEX.Conclusion: A high CODEX index is significantly associated with mortality or severe exacerbation outcomes in a pooled cohort from randomized interventional clinical trials.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 3761.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).