Physical activity good for COPD

Initiation of moderate-to-vigorous physical activity (MVPA) can help lower the risks of mortality and severe exacerbations for patients with chronic obstructive pulmonary disease (COPD), as reported in a study.

For the study, researchers conducted an emulated target trial. The study participants included individuals who were ≥40 years of age and were not performing MVPA prior to the COPD diagnosis and had at least one health screening visit before and after the index diagnosis.

MVPA was the main exposure and defined as vigorous aerobic exercise over 20 minutes performed daily for at least 3 days per week or moderate aerobic exercise over 30 minutes performed daily for at least 5 days per week. The primary outcome was the all-cause mortality rate, while the secondary outcome was the initial severe exacerbation measured as the time to event after COPD diagnosis.

The analysis involved 110,097 person-trials (27,564 in the MVPA group; 82,533 in the control group). No significant between-group differences were observed in the covariates after matching.

Compared with the control group, the MVPA group had a 16-percent decreased risk of all-cause mortality (adjusted hazards ratio [HR], 0.84, 95 percent confidence interval [CI], 0.79–0.89).

Subgroup analysis showed that MVPA had a stronger mortality-lowering effect for older vs younger patients (>65 vs <65 years of age), female vs male patients, those who never smoked vs smokers, and those with greater vs lower comorbidity (ie, higher vs lower Charlson comorbidity index [CCI]; p<0.05 for all).

The results for the risk of severe exacerbation were consistent with those for mortality, with the MVPA group having a lower risk than the control group (adjusted HR, 0.90, 95 percent CI, 0.87–0.94).

The researchers said that, despite the positive results of the study, personalized interventions may be necessary. More studies are needed to confirm the present data.