PT - JOURNAL ARTICLE AU - Borja G. Cosío AU - Sergi Pascual-Guardia AU - Alicia Borras-Santos AU - Germán Peces-Barba AU - Salud Santos AU - Laura Vigil AU - Juan José Soler-Cataluña AU - Cristina Martínez-González AU - Ciro Casanova AU - Pedro J. Marcos AU - Carlos J. Alvarez AU - José Luis López-Campos AU - Joaquim Gea AU - Judith Garcia-Aymerich AU - Jesús Molina AU - Miguel Román AU - Jorge Moises AU - Viktoria Szabo AU - Elizabeth A. Reagan AU - Raúl San José Estépar AU - George Washko AU - Alvar Agustí AU - Rosa Faner TI - Phenotypic characterisation of early COPD: a prospective case–control study AID - 10.1183/23120541.00047-2020 DP - 2020 Oct 01 TA - ERJ Open Research PG - 00047-2020 VI - 6 IP - 4 4099 - http://openres.ersjournals.com/content/6/4/00047-2020.short 4100 - http://openres.ersjournals.com/content/6/4/00047-2020.full SO - erjor2020 Oct 01; 6 AB - The phenotypic characteristics of chronic obstructive pulmonary disease (COPD) in individuals younger than 50 years of age (early COPD) are not well defined. This prospective, multicentre, case–control study sought to describe these characteristics and compare them with those of smokers (≥10 pack-years) of similar age with normal spirometry (controls).We studied 92 cases (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) <0.7) and 197 controls. Results were contrasted with participants with similar inclusion criteria recruited into the ECLIPSE and COPDGene cohorts.Cases had moderate airflow limitation (FEV1 71.3±20.8%) but were often symptomatic, used healthcare resources frequently, had air trapping (residual volume 150.6±55.5% ref.), had reduced diffusing capacity (84.2±20.7% ref.) and had frequent evidence of computed tomography (CT) emphysema (61%). Of note, less than half of cases (46%) had been previously diagnosed with COPD. Interestingly, they also often reported a family history of respiratory diseases and had been hospitalised because of respiratory problems before the age of 5 years more frequently than controls (12% versus 3%, p=0.009). By and large, these observations were reproduced when available in the ECLIPSE and COPDGene cohorts.These results show that early COPD is associated with substantial health impact and significant structural and functional abnormalities, albeit it is often not diagnosed (hence, treated). The fact that a sizeable proportion of patients with early COPD report a family history of respiratory diseases and/or early-life events (including hospitalisations before the age of 5 years) renders further support to the possibility of early-life origin of COPD.Early COPD is associated with substantial health impact, and structural and functional abnormalities, albeit it is often not diagnosed and hence, not treated. It is frequently associated with family history of respiratory diseases and early-life events. https://bit.ly/2ZtoRkp