Baseline characteristics from a 3-year longitudinal study to phenotype subjects with COPD: the FOOTPRINTS study

James D. Crapo*, Abhya Gupta, David A. Lynch, Alice M. Turner, Robert M. Mroz, Wim Janssens, Andrea Ludwig-Sengpiel, Harald Koegler, Anastasia Eleftheraki, Frank Risse, Claudia Diefenbach

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: FOOTPRINTS® is a prospective, longitudinal, 3-year study assessing the association between biomarkers of inflammation/lung tissue destruction and chronic obstructive pulmonary disease (COPD) severity and progression in ex-smokers with mild-to-severe COPD. Here, we present baseline characteristics and select biomarkers of study subjects.

Methods: The methodology of FOOTPRINTS® has been published previously. The study population included ex-smokers with a range of COPD severities (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stages 1–3), ex-smokers with COPD and alpha-1-antitrypsin deficiency (A1ATD) and a control group of ex-smokers without airflow limitation (EwAL). At study entry, data were collected for: demographics, disease characteristics, history of comorbidities and COPD exacerbations, symptoms, lung function and volume, exercise capacity, soluble biomarkers, and quantitative and qualitative computed tomography. Baseline data are presented with descriptive statistical comparisons for soluble biomarkers in the individual GOLD and A1ATD groups versus EwAL.

Results: In total, 463 subjects were enrolled. The per-protocol set comprised 456 subjects, mostly male (64.5%). The mean (standard deviation) age was 60.7 (6.9) years. At baseline, increasing pulmonary symptoms, worse lung function, increased residual volume, reduced diffusing capacity of the lung for carbon monoxide (DLco) and greater prevalence of centrilobular emphysema were observed with increasing disease severity amongst GOLD 1–3 subjects. Subjects with A1ATD (n = 19) had similar lung function parameters to GOLD 2–3 subjects, a high residual volume comparable to GOLD 3 subjects, and similar air trapping to GOLD 2 subjects. Compared with EwAL (n = 61), subjects with A1ATD had worse lung function, increased residual volume, reduced DLco, and a greater prevalence of confluent or advanced destructive emphysema. The soluble inflammatory biomarkers white blood cell count, fibrinogen, high-sensitivity C-reactive protein and plasma surfactant protein were higher in GOLD 1–3 groups than in the EwAL group. Interleukin-6 was expressed less often in EwAL subjects compared with subjects in the GOLD and A1ATD groups. Soluble receptor for advanced glycation end product was lowest in GOLD 3 subjects, indicative of more severe emphysema.

Conclusions: These findings provide context for upcoming results from FOOTPRINTS®, which aims to establish correlations between biomarkers and disease progression in a representative COPD population.

Trial registration number: NCT02719184, study start date 13/04/2016.
Original languageEnglish
Article number290
Number of pages15
JournalRespiratory research
Volume24
Issue number1
DOIs
Publication statusPublished - 17 Nov 2023

Bibliographical note

Funding:
This study was funded and sponsored by Boehringer Ingelheim. The trial clinical monitor for this study was Markus Beck (Boehringer Ingelheim Pharma GmbH & Co. KG, Dept. Clinical Research Germany/Respiratory Diseases, Birkendorfer Str. 65, 88397 Biberach an der Riss, Germany; Phone: + 49 (0) 7351 / 54 96 803).

Keywords

  • Chronic obstructive pulmonary disease
  • Emphysema
  • Biomarkers
  • Alpha 1 antitrypsin deficiency
  • Disease progression
  • FOOTPRINTS®
  • Baseline characteristics

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