EXACT-PRO correlates with FEV1 and systemic inflammation but not airway inflammation

Background: EXACT-PRO is a validated 14-item symptoms diary which captures COPD symptom control and is validated as a measure of exacerbation frequency. Whether the EXACT-PRO scores are related to the degree of airflow obstruction and markers of inflammation is uncertain. Hypothesis: There is a correlation between EXACT-PRO scores and health statues, airflow obstruction, systemic and airway inflammation. Method: Subjects with physician diagnosed COPD were recruited as part of a biomarker validation observational study. Eighty patients were prospectively evaluated by measuring markers of systemic inflammation (e.g. blood CRP) and airway inflammation (e.g. sputum neutrophil). Participants recorded the EXACT-PRO daily using an App on a smart phone to derive a 2 week mean. CAT, SGRQ and MRC questionnaires were recorded at a baseline stable visit. Results: The baseline values are shown in the Table. Univariate analyses showed that EXACT-PRO was significantly correlated with COPD symptoms and health status CAT, MRC, SGRQ, lung function FEV1, and the blood inflammatory indices NLR and blood neutrophils. The EXACT-PRO was not significantly correlated with the blood eosinophil, blood CRP, sputum eosinophil nor sputum neutrophil counts. Conclusion: There are statistically significant correlation between EXACT-PRO and health related quality of life, airflow obstruction and systemic inflammation but not markers of airway inflammation.