Late Breaking Abstract - Co-morbid disease clusters in chronic obstructive pulmonary disease: the ERICA study

Background: Comorbidities are common in Chronic Obstructive Pulmonary Disease (COPD), related to heterogeneity, morbidity and mortality. We aimed to identify disease clusters to examine overlap of extra-pulmonary manifestations in COPD. Methods: 729 GOLD II–IV COPD subjects underwent multiple phenotypic assessments, including aortic pulse wave velocity (aPWV) and isometric quadriceps strength, in a prospective, observational study. Baseline data was subject to k-means cluster analysis. Results: Four phenotypic clusters emerged: subjects with systemic inflammation, moderate airflow obstruction and frequent exacerbations (cluster 1), subjects without systemic inflammation but severe airflow obstruction (cluster 2), subjects with moderate airflow obstruction and vascular comorbidities (cluster 3) and fewer comorbidities (cluster 4). Elevated aPWV and muscle weakness were present across clusters 1, 2 and 3, yet functional and patient reported measures were worst within clusters 1 and 3. Conclusions: Distinct clusters of COPD identified in the ERICA cohort demonstrated that airflow limitation alone cannot predict the presence of extrapulmonary manifestations, vascular risks or functional limitation. ERICA was funded by a grant from Innovate UK and contributions in kind from GSK.