Chronic Obstruction Pulmonary Disease (COPD) is the fourth leading cause of death globally and is predicted to increase in the coming decades. Capturing systemic (extra-pulmonary) manifestations, in particular cardiovascular and musculoskeletal biomarkers that are often found in COPD patients are recognised to be of increasing clinical importance.
The Evaluation of the Role of Inflammation in non pulmonary disease manifestations in Chronic Airways disease (ERICA) study is interested in identifying/developing new biomarkers for COPD. The primary biomarkers of interest are fibrinogen, pulse wave velocity, and quadriceps maximum voluntary contraction, which have a known relationship with inflammation and may cause muscle or cardiovascular problems in COPD patients. In this study we explore these inter-relationships and determine if and how fibrinogen and other parameters; carotid intima-media thickness test, spirometry, a range of plasma and urine biomarkers, and questionnaire data can predict the longer-term outcomes in COPD patients.
The ERICA study is a multi-centre observational, non-interventional, epidemiological cohort study with a sample size of nearly 800 patients with COPD. Five UK centres with an interest in COPD undertook this study. These centres are based in Cambridge, Edinburgh, Cardiff, Nottingham and London.
The overarching aim of the ERICA consortium, which includes additional cohort studies such as ECLIPSE and ARCADE, is to relate systemic inflammation to non-pulmonary disease manifestations in COPD identified by candidate bedside biomarkers of cardiovascular and muscle function. The project will extend the understanding of these biomarkers through cross-sectional evaluation of subjects recruited from existing well-characterised cohorts in the UK and using experimental medicine hypothesis-testing trials in patients with evidence of systemic inflammation. The impact of this work will:
(i) generate evidence on stratification and the efficacy of biomarkers aimed to facilitate the design of smaller, more efficient Phase I-III clinical trials of medicines targeting inflammatory COPD subsets, thereby reducing failure rates of new medicines, and
(ii) supporting the development of two specific therapies thus validating a stratified medicine approach.