title: Symptoms and quality of life in patients with chronic obstructive pulmonary disease treated with aclidinium in a real-life setting.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a progressive disease with symptoms that can have a major impact on patients' physical health. The aim of this study was to evaluate quality of life (QoL), symptom severity and dyspnoea in COPD patients treated with aclidinium up to 24 weeks.
  
  
  METHODS
  In this prospective non-interventional multicentre study (198 centres in Sweden, Denmark, and Norway), COPD patients (age ≥40 years) who started treatment with aclidinium (initial therapy, change of treatment, or add-on therapy) could be included. Health-related QoL was obtained by COPD assessment test (CAT). Symptoms were evaluated on a 6-point Likert scale. The modified Medical Research Council (mMRC) Dyspnoea Scale was used as a simple grading system to assess the level of dyspnoea/shortness of breath from0 to 4. Patients on treatment with aclidinium who completed baseline and at least one follow-up visit (week 12 or 24) were included in the study population.
  
  
  RESULTS
  Overall, 1,093 patients were enrolled (mean 69 years, 54% females), one-third had ≥1 exacerbation the year prior to baseline. At enrolment, 48% were LAMA naïve. Mean (standard deviation, SD) CAT score decreased from 16.9 (7.7) at baseline to 14.3 (7.3) at week 24 (p<0.01) with a decrease in all individual CAT items (p<0.05). Mean difference in morning and night-time symptoms from baseline to week 24 was -0.60 (SD 2.51) and -0.44 (SD 2.48), respectively (both p<0.001). Mean (SD) mMRC Dyspnoea Scale changed from 1.6 (1.0) at baseline to 1.5 (1.0) at week 24 (p<0.001).
  
  
  CONCLUSIONS
  In this observational study of a Nordic real-life COPD population, treatment with aclidinium was associated with a clinically important improvement in QoL and morning and night-time symptoms, most pronounced in the LAMA naïve group. However, there is still room for improvement in the management of symptomatic COPD patients.
authors.affiliation: Section of Social Medicine, Department of Public Health, Copenhagen University, Copenhagen, Denmark.|Respiratory Section, Hvidovre Hospital, Copenhagen University, Copenhagen, Denmark; peter.lange@sund.ku.dk.
authors.forename: Peter
authors.initials: P
authors.lastname: Lange
authors.affiliation: Respiratory Section, Hvidovre Hospital, Copenhagen University, Copenhagen, Denmark.
authors.forename: Nina Skavlan
authors.initials: NS
authors.lastname: Godtfredsen
authors.affiliation: Airway Inflammation Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden.|Department of Internal Medicine, Trelleborg Hospital, Trelleborg, Sweden.
authors.forename: Beata
authors.initials: B
authors.lastname: Olejnicka
authors.affiliation: Vårdcentralen Näsby, Kristianstad, Sweden.
authors.forename: Bo-Anders
authors.initials: BA
authors.lastname: Paradis
authors.affiliation: Clinical Trial Center, Gothia Forum, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Curiac
authors.affiliation: Clinic of Allergology and Respiratory Medicine, Oslo, Norway.
authors.forename: Sjur
authors.initials: S
authors.lastname: Humerfelt
authors.affiliation: AstraZeneca Nordic-Baltic, Södertälje, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Telg
authors.affiliation: AstraZeneca Nordic-Baltic, Södertälje, Sweden.
authors.forename: Helene Nordahl
authors.initials: HN
authors.lastname: Christensen
authors.affiliation: Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark.
authors.forename: Magnus Alexander
authors.initials: MA
authors.lastname: Bitsch
authors.affiliation: Department of Applied Mathematics and Computer Science, Technical University of Denmark, Lyngby, Denmark.
authors.forename: Elisabeth Wreford
authors.initials: EW
authors.lastname: Andersen
authors.affiliation: Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
authors.forename: Leif
authors.initials: L
authors.lastname: Bjermer
keywords: COPD; LAMA; dyspnoea; observational study; patient satisfaction; patient-reported outcomes