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Record W4411165444 · doi:10.1183/23120541.00348-2025

Short-acting β <sub>2</sub> -agonist use, exacerbation risk and triple therapy in COPD: <i>post hoc</i> analyses of ETHOS

2025· article· en· W4411165444 on OpenAlexaff
John R. Hurst, Dave Singh, Fernando J. Martinez, Klaus F. Rabe, Patrick Darken, Niki Arya, Charlotta Movitz, Karin Bowen, Mehul Patel

Bibliographic record

VenueERJ Open Research · 2025
Typearticle
Languageen
FieldMedicine
TopicChronic Obstructive Pulmonary Disease (COPD) Research
Canadian institutionsAstraZeneca (Canada)
FundersManchester Biomedical Research CentreNational Institute for Health and Care ResearchAstraZeneca
KeywordsMedicinePost-hoc analysisExacerbationCOPDEthosPost hocIntensive care medicineInternal medicineLaw

Abstract

fetched live from OpenAlex

Background Short-acting β 2 -agonist (SABA) rescue therapy can relieve COPD symptoms. We assessed post-randomisation treatment effects on exacerbations and health-related quality of life in ETHOS by rescue SABA use. Methods In ETHOS ( NCT02465567 ), symptomatic people with COPD and an exacerbation history were randomly assigned 1:1:1:1 to budesonide/glycopyrronium/formoterol fumarate dihydrate (BGF) (320/14.4/10 or 160/14.4/10 μg), glycopyrronium/formoterol fumarate dihydrate (GFF) (14.4/10 μg) or budesonide/formoterol fumarate dihydrate (BFF) (320/10 μg). Post hoc analyses assessed exacerbation rates by baseline and post-randomisation SABA use (&gt;4 versus ≤4 inhalations·day −1 ), St George's Respiratory Questionnaire change from baseline by post-randomisation SABA use (&gt;4 versus ≤4 inhalations·day −1 ), and post-randomisation SABA use surrounding (30 days before, day of onset, 30 days after) the first exacerbation. Results Across treatments, higher moderate/severe exacerbation rates were observed for participants with higher (range: 1.62–2.51) versus lower (range: 1.14–1.51) SABA use at baseline or post-randomisation. Post-randomisation SABA use increased in the 30 days preceding, and decreased in the 30 days following, an exacerbation. Evidence of BGF benefit versus dual therapies in reducing moderate/severe exacerbation rates were seen regardless of SABA use level at baseline or post-randomisation, with greater BGF benefit observed versus GFF with higher SABA use (rate ratios (95% CI): high baseline SABA, 0.62 (0.53–0.72); high post-randomisation SABA, 0.64 (0.54–0.76)). Conclusion These results suggest increased SABA use is associated with an impending exacerbation. Further, BGF reduces exacerbation rates regardless of SABA use, with greater benefit in those with higher SABA use.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.479
Threshold uncertainty score0.849

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.002
Science and technology studies0.0000.001
Scholarly communication0.0000.001
Open science0.0010.001
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.143
GPT teacher head0.450
Teacher spread0.307 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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