Efficacy and Costs of Nutritional Rehabilitation in Muscle-Wasted Patients With Chronic Obstructive Pulmonary Disease in a Community-Based Setting: A Prespecified Subgroup Analysis of the INTERCOM Trial

In a 2-year RCT, 199 COPD patientswith moderate airflow obstruction  (FEV1%pred. 60%) and impaired exercise capacity were randomized to the interdisciplinary community-based COPD management program (INTERCOM) or usual care (UC). A prescheduled subgroup analysis was performed on 39 of the 199 patients who were muscle wasted and received UC or nutritional therapy in combination with exercise training. Body composition, muscle strength, and exercise capacity were assessed at baseline and 4, 12, and 24 months.

In muscle-wasted COPD patients a prolonged positive response to nutritional support integrated in a community-based rehabilitation program was shown. Both at 4 months and after 24 months  fat free mass index, body mass index, maximum inspiratory mouth pressure, quadriceps average power, 6-minute walking distance, cycle endurance time and peak exercise capacity were improved in favour of the intervention group.  After 4 months total costs were Euro 1501 higher in the intervention group than in the UC group, but not significantly different after 24 months. Hospital admission costs were significantly lower in the intervention group –€ 4724.

van Weteringa CR, Hoogendoorn M, Broekhuizen R, Geraerts-Keerisd GJ, De Munck DR, Rutten-van Molken MP, Schols AM.  Journal of the American Directors Association 2010; 11 (3): 179-187