PURPOSE: The BODE index, a multifactoral 10-point scale of health status in COPD, is reported to better predict mortality than FEV1. Patients with higher BODE scores are at more risk of death than patients with lower scores. The extent to which BODE is associated with other measurements of health status was explored in a post hoc analysis of data pooled from 2 identically designed, randomized, 12-week, clinical trials of long acting β2-agonist (LABA) treatment in COPD patients.
METHODS: Of 1456 subjects in the trials (age ∼63 yrs, FEV1 [percent predicted] ∼41%),1437 had the components of the BODE index (body mass index, FEV1 [percent predicted], dyspnea from the MRC, and 6 minute walk distance) evaluated at baseline prior to dosing at the start of the studies. The rank correlation between these BODE scores and the Baseline Dyspnea Index (BDI) and St. George's Hospital Respiratory Questionnaire total score (SGRQ) at baseline was determined. In addition, the relationship between the baseline BODE score and the change in these measurements (Transition Dyspnea Index focal score [TDI], change in SGRQ) after 6 weeks of LABA or placebo therapy was also evaluated.
RESULTS: The mean (SD) baseline BODE score was 4.45 (1.7) units. BODE scores were observed to have a moderate correlation with BDI (r = −0.37; 95% CI: −0.41, −0.32; p<0.0001) and baseline SGRQ total scores (r = 0.38; 95% CI: 0.33, 0.42; p<0.0001). However, change in these indices with placebo or LABA treatment at 6 weeks demonstrated no association with BODE scores (TDI r=0.0004, p=0.989; change in SGRQ r=0.034, p=0.2318).
CONCLUSION: In this analysis, the BODE index was moderately correlated with BDI and baseline SGRQ total scores, but was not correlated with change in these indices.
CLINICAL IMPLICATIONS: Baseline BODE was correlated with other baseline measures of patient symptoms and function. The relation between change in the BODE index with COPD treatment and changes in meaningful patient outcomes requires additional study.
DISCLOSURE: Claudia Cote, No Product/Research Disclosure Information; Consultant fee, speaker bureau, advisory committee, etc. Special Issues Board member for Sepracor Inc.