Chronic Obstructive Pulmonary Diseases : Journal of the COPD Foundation

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INTRODUCTION: In 2019, BLOCK-COPD (Beta-Blockers for the Prevention of Acute Exacerbations of Chronic Obstructive Pulmonary Disease) evaluated the effect of metoprolol on exacerbation risk and mortality in a COPD population without indications for beta-blocker use. We hypothesized that an imaging metric of coronary artery disease (CAD), the coronary artery calcium (CAC) score, would predict exacerbation risk and identify a differential response to metoprolol treatment. METHODS: The study population includes participants in BLOCK-COPD from multiple study sites...

Chronic obstructive pulmonary disease (COPD) is a significant public health concern and intercepting the development of emphysema is vital for COPD prevention. Smokers are a high-risk population for emphysema with limited prevention strategies. We aimed to determine if adherence to a nutritionally rich plant-centered diet among young ever-smokers is associated with reduced risk of future radiographic emphysema. We studied participants from the Coronary Artery Risk Development in Young Adults (CARDIA) Lung Prospective Cohort Study who were 18-30 years old at enrollment and followed for 30 years...

BACKGROUND: Low socioeconomic status (SES) has been associated with worse clinical outcomes in chronic obstructive pulmonary disease (COPD). Food insecurity is more common among individuals with low SES and has been associated with poor outcomes in other chronic illnesses, but its impact on COPD has not been studied. METHODS: Former smokers with spirometry-confirmed COPD were recruited from low-income areas of Baltimore, Maryland and followed for 9 months as part of a cohort study of diet and indoor air pollution...

RATIONALE: Prescription formularies specify which medications are available to patients. Formularies change frequently, potentially forcing patients to switch medications for non-clinical indications ("non-medical switching"). Non-medical switching is known to impact disease control and adherence. The consequences of non-medical switching have not been rigorously studied in COPD. METHODS: We conducted a cohort study of Veterans with COPD on inhaler therapy in January 2016 when formoterol was removed from the Department of Veterans Affairs (VA) national formulary...

RATIONALE: SPIROMICS is a prospective cohort study that enrolled 2,981 participants with the goal of identifying new COPD subgroups and intermediate markers of disease progression. Individuals with COPD and sleep apnea (OSA) experience impaired quality of life and more frequent exacerbations. COPD severity also associates with CT-scan based emphysema and alterations in airway dimensions. OBJECTIVES: To determine whether the combination of lung function and structure influences the risk of OSA among current and former smokers...

RATIONALE: Frailty is an increasingly recognized aspect of chronic obstructive pulmonary disease (COPD). The impact of frailty on long-term survival after admission to an Intensive Care Unit (ICU) due to an exacerbation of COPD has not been described. OBJECTIVE: To quantify the impact of frailty on time to death up to four years after admission to ICU in Australia and New Zealand with an exacerbation of COPD. METHODS: We performed a multicenter retrospective cohort study of adult patients admitted to 179 ICUs with a primary diagnosis of an exacerbation of COPD using the Australian and New Zealand Intensive Care Society Adult Patient Database from 1st January 2018 through 31st December 2020 in New Zealand, and 31st March 2022 in Australia...

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BACKGROUND: Chronic Obstructive Pulmonary Disease is a chronic, often progressive disease, which in most patients is caused by tobacco smoking. Our study focuses on differences in COPD-related outcomes between never-smokers, former smokers and current smokers. METHODS: A nationwide, population-based cohort study utilizing Danish health registries. Clinical and socioeconomical variables including smoking status, comorbidities, and dyspnoea were obtained. Poisson and Cox Regression were used to calculate the impact of these clinical parameters on risk of moderate and severe exacerbations and mortality during 12 months of follow-up...

PURPOSE: To test the feasibility of a novel self-management support intervention for people with chronic obstructive pulmonary disease (COPD). METHODS: We conducted a feasibility randomized controlled trial involving patients ≥40 years with severe or very severe COPD in New York, NY (n=59). Community health workers screened patients and addressed barriers to COPD self-management. Patients were also offered home-based pulmonary rehabilitation (HBPR) and an antibiotic and steroid rescue pack...

BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is an often-overlooked genetic condition that makes individuals susceptible to early-onset of Chronic Obstructive Pulmonary Disease (COPD). The established benefits of exercise-based Pulmonary Rehabilitation (PR) for usual COPD patients are unclear for those with underlying AATD, especially given potential differing muscle adaptations to exercise. This review seeks to compare PR outcomes between AATD and usual COPD patients, and to consolidate current knowledge on exercise intervention outcomes for the AATD population...

The advancement of artificial intelligence (AI) capabilities has paved the way for a new frontier in medicine, which has the capability to reduce the burden of COPD globally. AI may reduce healthcare-associated expenses while potentially increasing diagnostic specificity, improving access to early COPD diagnosis, monitoring of COPD progression, and subsequent management. We evaluated how AI can be integrated into COPD diagnosis globally and leveraged in resource-constrained settings. AI has been explored in diagnosing and phenotyping COPD through auscultation, pulmonary function testing (PFT), and imaging...

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by progressive obstruction of airways due to chronic inflammation. Both genetic and environmental factors are risk factors for COPD. The most common cause of COPD is smoking. However, evidence suggests that 17 to 38% of COPD patients are non-smokers, so other factors like air pollution may also play a role. OBJECTIVE: The relationship between serum exosomes and exposure to PM 2.5 and 10 µm in the residing environment of COPD patients and healthy groups was investigated...

BACKGROUND: Patients with alpha-1 antitrypsin deficiency (AATD) exhibit dysregulated inflammatory responses and a predilection for autoimmunity. While the adverse event (AE) profiles of COVID-19 vaccines in several chronic inflammatory conditions are now available, safety and tolerability data for patients with severe AATD have yet to be described. The feasibility of co-administering vaccines against COVID-19 and influenza in this population is similarly unclear. METHODS: We conducted a prospective study of 170 patients with Pi*ZZ AATD receiving their initial vaccination series with ChAdOx1 nCoV-19 (AstraZeneca)...

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive treatment option for patients with severe emphysema and hyperinflation refractory to optimal medical care. This therapy is effective in improving functional status and quality of life, underscoring the importance of identifying potential procedure candidates. To our knowledge, scalable strategies to improve referral for advanced lung disease patients are lacking. This quality improvement project aimed to increase identification and referral for BLVR in a large Veterans Affairs academic medical center...

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BACKGROUND: Despite studies investigating the publication rates and factors influencing publication outcomes of clinical trials in some disease fields, there is a notable lack of research focusing on chronic obstructive pulmonary disease (COPD) clinical trials. This study aims to explore the characteristics of COPD-related clinical trials and identify factors associated with publication status and publication time. METHODS: A systematic search was conducted on the WHO International Clinical Trials Registry Platform on April 28th, 2022, to identify completed interventional clinical trials related to COPD...

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Chronic obstructive pulmonary disease (COPD), a complaint described by progressive and inadequately reversible limitation in lungs with systemic inflammation, is largely current in India. There's no remedy available so far it is, thus, imperative to understand the underpinning pathogenesis of the complainant. A set of proteases known as Matrix metalloproteinase (MMPs) are especially involved in the process of alveolar destruction and mucus hypersecretion. There are responsible factors in an inheritable position to control COPD like MMPs and TIMPs (Tissue Inhibitor of Metalloproteinases)...

BACKGROUND: Currently approved therapies for individuals with alpha-1 antitrypsin deficiency (AATD) are intravenously infused products. The burdens and demographics of infusion practices in the United States are not well characterized. RESEARCH QUESTION: What is the prevalence of different infusion practices in the United States? STUDY DESIGN AND METHODS: AlphaNet disease management participants completed a survey that captured current and past infusion practices...