Characteristics, stability and outcomes of the 2011 GOLD COPD groups in the ECLIPSE cohort

The 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) patients with COPD into four groups (A to D).We explored the stability and relationship to outcomes of these groups within the (n=2101).Main results showed that: (1) these groups differed in several functional, imaging and biological characteristics in addition to those their own definition; (2) A and D groups were relatively stable over whereas groups B and C showed more temporal variability; (3) the risk of exacerbation over 3 years increased progressively from A to D, whereas hospitalization and mortality were lowest in A, highest in D and similar in B and C, despite the former having milder airflow limitation. prevalence of comorbidities and persistent systemic inflammation were group B.The different longitudinal behaviour of group A vs. B and C vs. pair with similar FEV1 values) supports the GOLD 2011 proposal of patients by more than FEV1 only. However the assumption that symptoms equate to risk appears to be naive, as groups B and C carry equally poor outcomes, though for different reasons