P260 Oral nutritional supplements in chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

Oral nutritional supplements (ONS) are often used to treat malnutrition in COPD, but the latest Cochrane review in COPD concluded that nutrition support, mainly involving ONS, did not improve anthropometry and other functional outcomes.[1][1] The latest NICE guidelines for the management of COPD recommend the use of ONS but state it is based on grade D evidence[2][2] despite previous reviews suggesting otherwise.[3][3] This review aimed to clarify the evidence base for ONS use in COPD. A systematic review identified 11 randomised controlled trials using ONS vs control (189 vs 185). Meta-analysis was performed of nutritional intake, weight, mid-arm muscle circumference (MAMC) and handgrip strength (HGS) (Comprehensive Meta-analysis v2). Quality of life, exercise capacity and respiratory outcomes were also examined. In contrast to previous Cochrane reviews, examining only data at the end of intervention,[1][1] this review examined the changes induced by ONS. Significantly improved energy intake was reported in six out of seven studies of which four were meta-analysable (+262 SE 104 kcal/d, p=0.012, random effect model, four RCT). Meta-analysis found ONS significantly improved body weight (+1.85 kg SE 0.25 kg, p