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105. Alpha-1 antitrypsin (AAT) augmentation and the liver phenotype of adults with AAT deficiency (genotype Pi*ZZ)

Author

Fromme, Malin, primary, Hamesch, Karim, additional, Schneider, Carolin V., additional, Mandorfer, Mattias, additional, Pons, Monica, additional, Thorhauge, Katrine, additional, Pereira, Vitor, additional, Sperl, Jan, additional, Frankova, Sona, additional, Reichert, Matthias C., additional, Benini, Federica, additional, Burbaum, Barbara, additional, Kleinjans, Moritz, additional, Amzou, Samira, additional, Rademacher, Laura, additional, Bewersdorf, Lisa, additional, Verbeek, Jef, additional, Nevens, Frederik, additional, Genesca, Joan, additional, Miravitlles, Marc, additional, Nuñez, Alexa, additional, Schaefer, Benedikt, additional, Zoller, Heinz, additional, Janciauskiene, Sabina, additional, Waern, Johan, additional, Oliveira, António, additional, Maia, Luís, additional, Simões, Carolina, additional, Mahadeva, Ravi, additional, Fraughen, Daniel D., additional, Trauner, Michael, additional, Krag, Aleksander, additional, Lammert, Frank, additional, Bals, Robert, additional, Gaisa, Nadine T., additional, Aigner, Elmar, additional, Griffiths, William J., additional, Denk, Helmut, additional, Teumer, Alexander, additional, McElvaney, Noel G., additional, Turner, Alice M., additional, Trautwein, Christian, additional, and Strnad, Pavel, additional

Published
2023
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107. Recommendations for the Implementation of the Self-Administration of Alpha-1 Antitrypsin

Author

Torres-Durán, María, primary, López-Campos, José Luis, additional, Calle Rubio, Myriam, additional, Montero-Martínez, Carmen, additional, Priegue Carrera, Ana, additional, Amaro Rodríguez, Rosanel, additional, Barrecheguren, Miriam, additional, Barrio Guirado, María Ángeles, additional, Callejas-González, Francisco Javier, additional, Casas-Maldonado, Francisco, additional, Diab-Cáceres, Layla, additional, García-Meseguer, Pilar, additional, Hernández-Pérez, José María, additional, Lázaro-Asegurado, Lourdes, additional, Martínez-González, Cristina, additional, Martínez Rivera, Carlos, additional, Michel, Francisco Javier, additional, Montoro-Ronsano, José-Bruno, additional, Sánchez, Raquel, additional, Ortiz-Pica, Marta, additional, Parra, Isabel, additional, Quintero García, José Pablo, additional, Ruiz-Serrano-de la Espada, María del Rosario, additional, Tortajada-Goitia, Begoña, additional, and Miravitlles, Marc, additional

Published
2023
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118. Respiratory symptoms and their determinants in the general Spanish population: changes over 20 years

Author

Miravitlles, Marc, Soler-Cataluña, Juan José, Soriano, Joan B., García-Rio, Francisco, de Lucas, Pilar, Alfageme, Inmaculada, Casanova, Ciro, Rodríguez González-Moro, José Miguel, Sánchez Herrero, María Guadalupe, Ancochea, Julio, Cosio, Borja G, Universitat Autònoma de Barcelona, [Miravitlles, Marc] Hosp Univ Vall Hebron, Dept Pneumol, Vall dHebron Inst Recerca, Barcelona, Spain, [Miravitlles, Marc] Inst Salud Carlos III, CIBER Enfermedades Respiratorias, Madrid, Spain, [Jose Soler-Cataluna, Juan] Inst Salud Carlos III, CIBER Enfermedades Respiratorias, Madrid, Spain, [Soriano, Joan B.] Inst Salud Carlos III, CIBER Enfermedades Respiratorias, Madrid, Spain, [Garcia-Rio, Francisco] Inst Salud Carlos III, CIBER Enfermedades Respiratorias, Madrid, Spain, [Ancochea, Julio] Inst Salud Carlos III, CIBER Enfermedades Respiratorias, Madrid, Spain, [Cosio, Borja G.] Inst Salud Carlos III, CIBER Enfermedades Respiratorias, Madrid, Spain, [Jose Soler-Cataluna, Juan] Hosp Arnau Vilanova Lliria, Serv Neumol, Valencia, Spain, [Soriano, Joan B.] Hosp Univ Princesa, Serv Neumol, Madrid, Spain, [Ancochea, Julio] Hosp Univ Princesa, Serv Neumol, Madrid, Spain, [Soriano, Joan B.] Univ Autonoma Madrid, Madrid, Spain, [Ancochea, Julio] Univ Autonoma Madrid, Madrid, Spain, [Garcia-Rio, Francisco] Hosp Univ Paz IdiPAZ, Serv Neumol, Madrid, Spain, [De Lucas, Pilar] Hosp Gen Gregorio Maranon, Serv Neumol, Madrid, Spain, [Alfageme, Inmaculada] Univ Seville, Hosp Univ Virgen Valme, Unidad Gest Clin Neumol, Seville, Spain, [Casanova, Ciro] Hosp Univ Nuestra Senora Candelaria, Serv Neumol, Tenerife, Spain, [Rodriguez Gonzalez-Moro, Jose Miguel] Univ Alcala, Hosp Univ Principe Asturias Alcala De Henares, Serv Neumol, Madrid, Spain, [Sanchez, Guadalupe] GSK, Dept Med, Madrid, Spain, [Cosio, Borja G.] Hosp Univ Son Espases IdISBa, Serv Neumol, Palma de Mallorca, Spain, Institut Català de la Salut, [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. [Soler-Cataluña JJ] CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Valencia, Spain. [Soriano JB] CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. Servicio de Neumología, Hospital Universitario La Princesa, and Universidad Autónoma de Madrid, Madrid, Spain. [García-Río F] CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain. Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain. [de Lucas P] Servicio de Neumología, Hospital General Gregorio Marañon, Madrid, Spain. [Alfageme I] Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Universidad de Sevilla, Seville, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Pulmonary and Respiratory Medicine, Questionnaire, Other subheadings::Other subheadings::/epidemiology [Other subheadings], Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores], técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::morbilidad::prevalencia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Community, Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Physical-activity survey, Scale, Dyspnea, Respiratory Tract Diseases::Lung Diseases [DISEASES], Validation, Adults, Pulmons - Malalties - Epidemiologia, enfermedades respiratorias::enfermedades pulmonares [ENFERMEDADES], Copd, Mortality
Abstract

BackgroundFew large epidemiological studies have analysed the prevalence of respiratory symptoms and their determinants in the general adult population. We investigated the prevalence and determinants of respiratory symptoms and compared their prevalence with that of two previous studies conducted in 1999 and 2009.MethodEPISCAN II was a multicentre, cross-sectional, population-based epidemiological study in individuals older than 40 years.ResultsA total of 9092 individuals were included. Up to 47.5% reported at least one respiratory symptom, being more frequent in women than in men (49.4%versus45.5%, p=0.0002) and with wheezing being the most frequent (33.7%) followed by dyspnoea (26.8%). The presence of any symptom was associated with female sex, higher body mass index (BMI), lower forced expiratory volume in 1 s (FEV1% pred), reduced physical activity, a higher Charlson index and the presence of anxiety and depression. Smoking was also significantly associated with having at least one respiratory symptom in a dose–response fashion (OR: 1.415, 1.916, 2.192 and 2.987 for 0–10, 10–20, 20–30 and >30 pack-years, respectively, all pConclusionsApproximately half of the adult Spanish population have respiratory symptoms and this prevalence has remained quite stable over the last 20 years. Smoking remains the main factor associated with respiratory symptoms, but female sex, comorbidities, high BMI and low FEV1and low physical activity are also significantly associated with respiratory symptoms.

Published
2022

120. Prevalence and management of COPD and heart failure comorbidity in the general practitioner setting

Author

Pais, A., Cosseddu, S., Dessì, M.A., Accardo, G., Frau, D., Peruzzu, I., Uda, F., Idda, G., Sini, C., Piro, S., Muscas, A., Arno, P., Manca, A., Serra, F., Deiana, G., Pintori, G., Canu, M.G., Fanari, G., Setzu, S., Vaccargiu, A.M., Vincis, B., Schirru, M.T., Maureddu, P.P., Dall'Acqua, P., Contini, R., Meloni, M., Martinetti, M., Granara, A.R., Massa, S., Cadeddu, M.G., Mariani, B., Urru, C., Ambu, R., Meloni, M.C., Puddu, S., Spano, F., Musa, S., Corona, M., Pirina, Pietro, Martinetti, Marco, Spada, Claudia, Zinellu, Elisabetta, Pes, Rosanna, Chessa, Efisio, Fois, Alessandro Giuseppe, and Miravitlles, Marc

Published
2017
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121. Impact of alcohol consumption on the liver phenotype in alpha-1 antitrypsin deficiency

Author

Fromme, Malin, primary, Schneider, Carolin V., additional, Gueldiken, Nurdan, additional, Amzou, Samira, additional, Luo, Yizhao, additional, Pons, Monica, additional, Genesca, Joan, additional, Miravitlles, Marc, additional, Thorhauge, Katrine, additional, Waern, Johan, additional, Sperl, Jan, additional, Frankova, Sona, additional, Bartel, Marc, additional, Zimmer, Holger, additional, Zorn, Markus, additional, Krag, Aleksander, additional, Turner, Alice, additional, Trautwein, Christian, additional, and Strnad, Pavel, additional

Published
2023
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122. Updating the ATS/ERS Task Force Report on Outcomes for COPD Pharmacological Trials

Author

Cazzola, Mario, primary, Rogliani, Paola, additional, Barnes, Peter J, additional, Blasi, Francesco, additional, Celli, Bartolome, additional, Hanania, Nicola A, additional, Martinez, Fernando J., additional, Miller, Bruce E, additional, Miravitlles, Marc, additional, Page, Clive P., additional, Tal-Singer, Ruth, additional, and Matera, Maria Gabriella, additional

Published
2023
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128. Spanish Registry of Patients With Alpha-1 Antitrypsin Deficiency: Database Evaluation and Population Analysis

Author

Lara, Beatriz, Blanco, Ignacio, Martínez, María Teresa, Rodríguez, Esther, Bustamante, Ana, Casas, Francisco, Cadenas, Sergio, Hernández, José M., Lázaro, Lourdes, Torres, María, Curi, Sergio, Esquinas, Cristina, Dasí, Francisco, Escribano, Amparo, Herrero, Inés, Martínez-Delgado, Beatriz, Michel, Francisco Javier, Rodríguez-Frías, Francisco, and Miravitlles, Marc

Published
2017
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129. Registro español de pacientes con déficit de alfa-1 antitripsina: evaluación de la base de datos y análisis de la población incluida

Author

Lara, Beatriz, Blanco, Ignacio, Martínez, María Teresa, Rodríguez, Esther, Bustamante, Ana, Casas, Francisco, Cadenas, Sergio, Hernández, José M., Lázaro, Lourdes, Torres, María, Curi, Sergio, Esquinas, Cristina, Dasí, Francisco, Escribano, Amparo, Herrero, Inés, Martínez-Delgado, Beatriz, Michel, Francisco Javier, Rodríguez-Frías, Francisco, and Miravitlles, Marc

Published
2017
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133. Stepwise management of COPD: What is next after bronchodilation?

Author

Miravitlles, Marc, Matsunaga, Kazuto, and Dreher, Michael

Subjects
CHRONIC obstructive pulmonary disease, PATIENT compliance
Abstract

Inhaled bronchodilator therapy with long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) in combination is currently the mainstay of treatment for chronic obstructive pulmonary disease (COPD). Treatment guidelines recommend the addition of inhaled corticosteroids (ICS) to LABA/LAMA only in patients with a history of frequent/severe exacerbations and high blood eosinophil counts, or in those with concomitant asthma. Despite this, real-world data suggest that clinicians are not adhering to this guidance and that ICS are frequently overused. This is possibly due to the incorrect assumption that when LABA/LAMA therapy is not sufficient, adding an ICS to the treatment regimen is the logical next step. In this narrative review, we describe global and country-specific guideline recommendations from Germany, Spain, and Japan and compare these with real-world data on LABA/LAMA and ICS use in clinical practice. We also provide a clinical guide to the use of add-on therapies with LABA/LAMA for different patient phenotypes, including (1) patients still symptomatic (but not exacerbating) despite LABA/LAMA treatment; (2) patients still exacerbating despite LABA/LAMA treatment who have high blood eosinophil counts; and (3) patients still exacerbating despite LABA/LAMA treatment who do not have high blood eosinophils or concomitant asthma. Plain language summary: What are the options for patients with COPD when LABA/LAMA is not enough? Treatment guidelines for chronic obstructive pulmonary disease (COPD) recommend dual bronchodilator therapy for the majority of patients, consisting of an inhaled combination of long-acting β2-agonist (LABA) and long-acting muscarinic antagonist (LAMA). Patients whose COPD is not well controlled on LABA/LAMA require further clinical intervention, which may or may not involve treatment with additional drugs. Data from observational studies reflecting routine clinical practice suggest that inhaled corticosteroids (ICS) are often added to LABA/LAMA, even though treatment guidelines recommend only adding ICS in a specific group of patients with a history of exacerbations and high levels of eosinophils (a type of inflammatory cell) in the blood, or in those with current asthma. As long-term ICS use may be associated with an increased risk of side effects such as pneumonia, it is important to avoid overuse of ICS. When a patient's COPD is not well controlled on LABA/LAMA, other treatable conditions should first be ruled out, and factors such as medication adherence, inhaler technique, and co-existing health conditions should also be considered. This review gives advice on what follow-up options physicians should consider when LABA/LAMA is not providing adequate control of a patient's COPD. Specifically, recommendations are given for three different patient profiles: 1. Patients who still have symptoms of COPD (but no acute/sudden worsenings of symptoms, known as exacerbations). 2. Patients who have exacerbations, as well as high levels of eosinophils in the blood. 3. Patients who have exacerbations, but without high levels of eosinophils in the blood or current asthma. [ABSTRACT FROM AUTHOR]

Published
2023
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136. Distribution of alpha1 antitrypsin rare alleles in six countries: Results from the Progenika diagnostic network

Author

López-Campos Bodineau, José Luis, Rapun, Noelia, Czischke, Karen, Jardim, José R, Fernandez Acquier, Mariano, ALÍ MUNIVE, ABRAHAM, Miravitlles, Marc, Institut Català de la Salut, [Lopez-Campos JL] Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain. [Rapun N] Progenika Biopharma, a Grifols Company. Derio, Vizcaya, Spain. [Czischke K] Departamento de Neumología, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile. [Jardim JR] Centro de Reabilitação Pulmonar da Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM/Unifesp), São Paulo, Brazil. [Acquier MF] Servicio de Neumonología, Hospital Cetrángolo, Vicente López, Buenos Aires, Argentina. [Munive AA] Departamento Médico, Fundación Neumológica Colombiana, Bogotá, D.C., Colombia. [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Pulmons - Malalties, Genetic Phenomena::Genotype [PHENOMENA AND PROCESSES], enfermedades respiratorias::enfermedades pulmonares::deficiencia de alfa 1-antitripsina [ENFERMEDADES], Respiratory Tract Diseases::Lung Diseases::alpha 1-Antitrypsin Deficiency [DISEASES], Genetic Phenomena::Genetic Structures::Genome::Genome Components::Genes::Alleles [PHENOMENA AND PROCESSES], Genotip, fenómenos genéticos::genotipo [FENÓMENOS Y PROCESOS], fenómenos genéticos::estructuras genéticas::genoma::componentes genómicos::genes::alelos [FENÓMENOS Y PROCESOS], Alfa 1-antitripsina
Abstract

Alpha1 antitrypsin deficiency; Diagnosis; Rare alleles Dèficit d'alfa1 antitripsina; Diagnòstic; Al·lels rars Déficit de alfa1 antitripsina; Diagnóstico; Alelos raros Background Knowledge of the frequency of rare SERPINA1 mutations could help in the management of alpha1 antitrypsin deficiency (AATD). The present study aims to assess the frequencies of rare and null alleles and their respiratory and hepatic pathogenicity. Methods This is a secondary analysis of a study that evaluated the viability of the Progenika diagnostic genotyping system in six different countries by analyzing 30,827 samples from cases of suspected AATD. Allele-specific genotyping was carried out with the Progenika A1AT Genotyping Test which analyses 14 mutations in buccal swabs or dried blood spots samples. SERPINA1 gene sequencing was performed for serum AAT-genotype discrepancies or by request of the clinician. Only cases with rare mutations were included in this analysis. Results There were 818 cases (2.6%) carrying a rare allele, excluding newly identified mutations. All were heterozygous except for 20 that were homozygous. The most frequent alleles were the M-like alleles, PI*Mmalton and PI*Mheerlen. Of the 14 mutations included in the Progenika panel, there were no cases detected of PI*Siiyama, PI*Q0granite falls and PI*Q0west. Other alleles not included in the 14-mutation panel and identified by gene sequencing included PI*Mwürzburg, PI*Zbristol, and PI*Zwrexham, and the null alleles PI*Q0porto, PI*Q0madrid, PI*Q0brescia, and PI*Q0kayseri. Conclusions The Progenika diagnostic network has allowed the identification of several rare alleles, some unexpected and not included in the initial diagnostic panel. This establishes a new perspective on the distribution of these alleles in different countries. These findings may help prioritize allele selection for routine testing and highlights the need for further research into their pathogenetic role.

Published
2023

140. Severe COVID-19 Illness and α1-Antitrypsin Deficiency: COVID-AATD Study

Author

Rodríguez Hermosa, Juan Luis, primary, Vargas Centanaro, Gianna, additional, González Castro, María Estela, additional, Miravitlles, Marc, additional, Lázaro-Asegurado, Lourdes, additional, Jiménez-Rodríguez, Beatriz María, additional, Rodríguez, Rosanel Amaro, additional, Moreno Méndez, Rosaly, additional, Torres-Duran, María, additional, Hernández-Pérez, José María, additional, Humanes-Navarro, Ana María, additional, and Calle Rubio, Myriam, additional

Published
2023
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141. Exacerbations in COPD: a personalised approach to care

Author

José Soler-Cataluña, Juan, primary, Miravitlles, Marc, additional, Fernández-Villar, Alberto, additional, Izquierdo, José Luis, additional, García-Rivero, Juan Luis, additional, Cosio, Borja G, additional, López-Campos, José Luis, additional, and Agustí, Alvar, additional

Published
2023
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142. Prediction of liver-related endpoints by non-invasive fibrosis tests – longitudinal follow-up in adults with severe alpha-1 antitrypsin deficiency (Pi*ZZ genotype)

Author

Fromme, Malin, additional, Amzou, Samira, additional, Burbaum, Barbara, additional, Striedl, Philipp, additional, Mandorfer, Mattias, additional, Pons, Monica, additional, Genesca, Joan, additional, Miravitlles, Marc, additional, Thorhauge, Katrine, additional, Schäfer, Benedikt, additional, Zoller, Heinz, additional, Krag, Aleksander, additional, Aigner, Elmar, additional, Trautwein, Christian, additional, and Strnad, Pavel, additional

Published
2023
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143. Prevalence of reduced lung diffusing capacity and CT scan findings in smokers without airflow limitation: a population-based study

Author

Garcia-Rio, Francisco, primary, Miravitlles, Marc, additional, Soriano, Joan B, additional, Cosío, Borja G, additional, Soler-Cataluña, Juan José, additional, Casanova, Ciro, additional, de Lucas, Pilar, additional, Alfageme, Inmaculada, additional, Rodríguez González-Moro, José Miguel, additional, Sánchez Herrero, María Guadalupe, additional, and Ancochea, Julio, additional

Published
2023
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148. Prevalence of reduced lung diffusing capacity and CT scan findings in smokers without airflow limitation : a population-based study

Author

García-Rio, Francisco, Miravitlles, Marc, Soriano, Joan B, Cosio, Borja G, Soler-Cataluña, Juan José, Casanova, Ciro, de Lucas, Pilar, Alfageme, Inmaculada, Rodríguez González-Moro, José Miguel, Sánchez Herrero, María Guadalupe, Ancochea, Julio, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Garcia-Rio F] Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ, Universidad Autónoma de Medicina, Madrid, Spain. Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain. [Miravitlles M] Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain. Servei de Pneumologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Soriano JB] Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain. Servicio de Neumología, Hospital Universitario La Princesa, Madrid, Spain. Universidad Autónoma de Madrid, Madrid, Spain. [Cosío BG] Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain. Servicio de Neumología, Hospital Universitario Son Espases-IdiSBa, Palma de Mallorca, Spain. [Soler-Cataluña JJ] Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain. Servicio de Neumología, Hospital Arnau de Vilanova-Lliria, Departamento de Medicina, Universitat de València, Valencia, Spain. [Casanova C] Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain. Pulmonary Deparment-Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Universidad de La Laguna, Tenerife, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Image Interpretation, Computer-Assisted::Tomography, X-Ray Computed [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Pulmonary and Respiratory Medicine, Tobacco and the lung, Pulmons - Tomografia, diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::interpretación de imágenes asistida por ordenador::tomografía computarizada por rayos X [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Lung Physiology, técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::morbilidad::prevalencia [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], personas::fumadores [DENOMINACIONES DE GRUPOS], Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Imaging/CT MRI etc, Inorganic Chemicals::Carbon Compounds, Inorganic::Carbon Monoxide [CHEMICALS AND DRUGS], Fumadors, Monòxid de carboni, Persons::Smokers [NAMED GROUPS], compuestos inorgánicos::compuestos inorgánicos del carbono::monóxido de carbono [COMPUESTOS QUÍMICOS Y DROGAS], Exercise
Abstract

BackgroundPopulation distribution of reduced diffusing capacity of the lungs for carbon monoxide (DLCO) in smokers and main consequences are not properly recognised. The objectives of this study were to describe the prevalence of reduced DLCO in a population-based sample of current and former smoker subjects without airflow limitation and to describe its morphological, functional and clinical implications.MethodsA sample of 405 subjects aged 40 years or older with postbronchodilator forced expiratory volume in 1 s/forced vital capacity (FVC) >0.70 was obtained from a random population-based sample of 9092 subjects evaluated in the EPISCAN II study. Baseline evaluation included clinical questionnaires, exhaled carbon monoxide (CO) measurement, spirometry, DLCO determination, 6 min walk test, routine blood analysis and low-dose CT scan with evaluation of lung density and airway wall thickness.ResultsIn never, former and current smokers, prevalence of reduced DLCO was 6.7%, 14.4% and 26.7%, respectively. Current and former smokers with reduced DLCO without airflow limitation were younger than the subjects with normal DLCO, and they had greater levels of dyspnoea and exhaled CO, greater pulmonary artery diameter and lower spirometric parameters, 6 min walk distance, daily physical activity and plasma albumin levels (all pConclusionReduced DLCO is a frequent disorder among smokers without airflow limitation, associated with decreased exercise capacity and with CT findings suggesting that it may be a marker of smoking-induced early vascular damage.Trial registration numberNCT03028207.

Published
2023

150. Inhaled Corticosteroid Use Among COPD Patients in Primary Care in Spain

Author

Miravitlles, Marc, Roman-Rodríguez, Miguel, Ribera, Xavier, Ritz, John, Izquierdo, José Luis, Institut Català de la Salut, [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. [Roman-Rodríguez M] Centro de Salud Dra. Teresa Pique, Mallorca, Spain. Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Mallorca, Spain. [Ribera X] Boehringer Ingelheim España, Barcelona, Spain. [Ritz J] Syneos Health - Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA. [Izquierdo JL] Department of Medicine and Medical Specialties, Universidad de Alcalá, Madrid, Spain. Pneumology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones [CHEMICALS AND DRUGS], Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [DISEASES], Primary Health Care, Otros calificadores::/uso terapéutico [Otros calificadores], Corticosteroides - Ús terapèutic, General Medicine, Pulmons - Malalties obstructives - Tractament, International Journal of Chronic Obstructive Pulmonary Disease, enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica [ENFERMEDADES], chronic obstructive pulmonary disease, Bronchodilator Agents, primary care, Pulmonary Disease, Chronic Obstructive, Cross-Sectional Studies, exacerbations, Adrenal Cortex Hormones, Spain, Administration, Inhalation, hormonas, sustitutos de hormonas y antagonistas de hormonas::hormonas::hormonas de la corteza suprarrenal [COMPUESTOS QUÍMICOS Y DROGAS], Humans, Other subheadings::/therapeutic use [Other subheadings], inhaled corticosteroids, Original Research
Abstract

Marc Miravitlles,1 Miguel Roman-Rodríguez,2,3 Xavier Ribera,4 John Ritz,5 José Luis Izquierdo6,7 On behalf of OPTI investigator’s group1Pneumology Department, Hospital Universitari Vall d´Hebron/Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 2Centro de Salud Dra. Teresa Pique, Mallorca, Spain; 3Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Mallorca, Spain; 4Boehringer Ingelheim España, Sant Cugat del Vallés, Barcelona, Spain; 5Syneos Health - Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 6Department of Medicine and Medical Specialties, Universidad de Alcalá, Madrid, Spain; 7Pneumology Department, Hospital Universitario de Guadalajara, Guadalajara, SpainCorrespondence: Marc Miravitlles,Pneumology Department, Hospital Universitari Vall d’Hebron, P. Vall d’Hebron 119-129, Barcelona, ES– 08035, Spain, Email marcm@separ.esPurpose: Inhaled corticosteroids (ICS) are frequently used to treat chronic obstructive pulmonary disease (COPD) outside the current recommendations. Our aim was to describe ICS use in COPD patients and to identify factors associated with ICS use among COPD patients treated within primary care in Spain.Patients and Methods: This was a cross-sectional, non-interventional and multicenter study of patients with COPD treated in primary care. Patient characteristics and exacerbations were described in terms of ICS use among the overall cohort, and among those with spirometry confirmed COPD (post-bronchodilator forced expiratory volume in 1 second [FEV1]/forced vital capacity [FVC] ratio < 70%). Multivariable logistic regression was used to identify factors associated with ICS use.Results: A total of 901 patients were included, of which 47.9% (n = 432) were treated with ICS. A total of 240 patients (26.6%) experienced moderate/severe exacerbations in the prior year, while 309 (34.3%) during the previous two years. History of asthma totaled 11.6% (n = 105). The most frequent phenotype was non-exacerbator (51.6%), and the proportion of patient with moderate or severe exacerbations was significantly higher among ICS treated patients compared to non-treated: 37.5% versus 16.6% during the previous year (p < 0.001), and 46.8% versus 22.8% during the previous 2-years (p < 0.001), respectively. Patient characteristics were similar among spirometry confirmed patients and the overall population. Factors significantly associated with ICS use were a history of asthma (OR = 4.39, 95% CI: 2.67– 7.26), the presence of moderate or severe exacerbations in the last year (OR = 2.52, 95% CI: 1.81– 3.49), followed by higher mMRC and higher CAT score.Conclusion: Nearly half of patients in primary care in Spain are treated with ICS, despite most of them being non-exacerbators. History of asthma, exacerbations, and worse dyspnea and CAT scores are associated with ICS use.Keywords: chronic obstructive pulmonary disease, primary care, inhaled corticosteroids, exacerbations

Published
2022

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