Abstract
Background Chronic obstructive pulmonary disease (COPD) is commonly diagnosed when the airflow limitation is well established and symptomatic.
Aim We aimed to identify individuals at risk of developing COPD according to the concept of pre-COPD and compare their clinical characteristics with (1) those who have developed the disease at a young age, and (2) the overall population with and without COPD.
Methods The EPISCAN II study is a cross-sectional, population-based study aimed to investigate the prevalence of COPD in Spain in subjects≥ 40 years. Pre-COPD was defined as the presence of emphysema>5% and/or bronchial thickening by CT scan and/or DLCO<80% in subjects with respiratory symptoms and post-bronchodilator FEV1/FVC>0.70. Young COPD, was defined as FEV1/FVC<0.70 in a subject ≤50 years. Demographic and clinical characteristics were compared among pre-COPD, Young COPD and the overall population with and without COPD.
Results Among the 1,077 individuals with FEV1/FVC<0.70, 65 (6.0%) were≤50 years. Among the 8,015 individuals with FEV1/FVC>0.70, 350 underwent both DLCO test and chest CT scan. Of those, 78 (22.3%) subjects fulfilled the definition of pre-COPD. Subjects with pre-COPD were older, predominantly women, less frequently active or ex- smokers, with less frequent previous diagnosis of asthma but with higher symptomatic burden than those with Young COPD.
Conclusions 22.3% of the studied population was at risk of developing COPD, with similar symptomatic and structural changes than those with well-stablished disease without airflow obstruction. This COPD at risk population is different from those that develop COPD at young age.
Footnotes
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Conflict of interest: Borja G Cosio has received speaker or consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Menarini, Novartis, Sanofi, TEVA, and research grants from Menarini, AstraZeneca and Boehringer-Ingelheim.
Conflict of interest: Ciro Casanova has received speaker or consulting fees from AstraZeneca, Bial, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Menarini, Novartis, and research grants from GlaxoSmithKline, Menarini and AstraZeneca.
Conflict of interest: Juan José Soler-Cataluña has received speaker fees from AstraZeneca, Bial, Boehringer Ingelheim, Chiesi, Esteve, Ferrer, GlaxoSmithKline, Menarini, Novartis and Teva, and and consulting fees from AstraZeneca, Bial, Boehringer Ingelheim, GlaxoSmithKline, Ferrer and Novartis.
Conflict of interest: Francisco García-Río has received speaker or consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Menarini, Novartis, Pfizer and Rovi, and research grants from Chiesi, Esteve, Gebro Pharma, GlaxoSmithKline, Menarini and TEVA.
Conflict of interest: Inmaculada Alfageme has no conflicto of interest. Guadalupe Sanchez is a GSK employee within the Medical Department.
Conflict of interest: Julio Ancochea has received speaker or consulting fees from Actelion, Air Liquide, Almirall, AstraZeneca, Boehringer Ingelheim, Carburos Médica, Chiesi, Faes Farma, Ferrer, GlaxoSmithKline, InterMune, Linde Healthcare, Menarini, MSD, Mundipharma, Novartis, Pfizer, Roche, Rovi, Sandoz, Takeda y Teva.
Conflict of interest: Marc Miravitlles has received speaker or consulting fees from AstraZeneca, Bial, Boehringer Ingelheim, Chiesi, Cipla, CSL Behring, Laboratorios Esteve, Gebro Pharma, Kamada, GlaxoSmithKline, Grifols, Menarini, Mereo Biopharma, Novartis, pH Pharma, Palobiofarma SL, Rovi, TEVA, Spin Therapeutics, Verona Pharma and Zambon, and research grants from Grifols.
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- Received July 6, 2022.
- Accepted August 24, 2022.
- Copyright ©The authors 2022
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