Age, gender, and race all influence the natural history of chronic obstructive pulmonary disease (COPD), along with the impact of comorbid conditions, chronic bronchitis, exacerbations, and asthma-COPD overlap (ACO). This according to a recent review that examined the major advances in the clinical epidemiology of COPD from the first 10 years of the COPDGene study, a longitudinal study of >10,000 subjects, including smokers with a ≥10 pack year history with and without COPD and healthy never smokers, to characterize disease-related phenotypes and explore associations to susceptibility genes. Among the highlights:
- In COPDGene, historical exacerbation rates were nearly twice as high in those with chronic bronchitis (CB) as in those without CB.
- Those with ACO represent a distinct high-risk population with a high propensity for exacerbations.
- There are important gender and racial differences in the phenotypic expression of COPD. These differences translate into higher risk of disease severity, particularly in women.
- Understanding the influence of various comorbidities should be an integral part of the care of COPD patients.
Maselli DJ, et al. Clinical epidemiology of COPD – Insights from 10 years of the COPDGene study. [Published online ahead of print May 30, 2019]. CHEST. doi: 10.1016/j.chest.2019.04.135.