The frequency of exacerbations appears to differ between countries that contributed to clinical trials with COPD patients. This has emerged from a systematic analysis of three clinical trials, conducted in the blue journal popped up.
Exacerbations are an important endpoint in international clinical trials in COPD patients. The number of observed exacerbations is often lower than expected and seems to vary from country to country. This analysis reviewed data from 3 large international randomized trials conducted over an 18-year period. The study design and disease severity of the participating patients differed and the studies were aimed at a comparison between the use of bronchodilators and/or inhaled corticosteroids and bronchodilators alone and/or placebo.
For the nearly 30,000 patients in the 41 countries analysed, the mean frequency of lung attacks was two to three times different between the highest and lowest tertiles of the recruiting countries. These differences could not be explained by demographics, study protocol, or past exacerbations. Of the 18 countries that contributed to all studies, half of the countries in the highest or lowest tertiles of exacerbations in all trials remained in these tertiles. Severe lung attacks had a different ranking internationally.
These differences help explain why large studies have been needed to show differences between treatments that reduce the risk of lung attacks.
Bron:
Calverley PM, Martinez FJ, Vestbo J, et al. International Differences in the Frequency of Chronic Obstructive Pulmonary Disease Exacerbations Reported in Three Clinical Trials. Am J Respir Crit Care Med. 2022;206:25-33.