Impact of gender on COPD expression in a real-life cohort

Roche, N.; Deslée, G.; Caillaud, D.; Brinchault, Graziella; Court-Fortuné, Isabelle; Nesme-Meyer, Pascale; Surpas, P.; Escamilla, R.; Pérez, Thierry; Chanez, Pascal; Pinet, C.; Jébrak, G.; Paillasseur, Jean-Louis; Burgel, Pierre‐Régis

doi:10.1186/1465-9921-15-20

Cited by 38 publications

(35 citation statements)

References 15 publications

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“…Despite increased diagnosis of COPD in women and the different disease expression,[44] our data failed to find an association with follow-up time. This is probably because the majority of our patients were males and peak COPD prevalence rates in women have yet to be seen.…”

Section: Discussioncontrasting

confidence: 67%

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

Lόpez-Campos

Fernández-Villar

Represas-Represas

et al. 2017

European Clinical Respiratory Journal

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Background: COPD is a chronic disease traditionally associated with increased symptoms as lung function deteriorates. Follow-up times in previous cohort studies were limited to a few years. Interestingly, newer longer observational studies show a more comprehensive picture on disease progression over time. Therefore, the question on the relevancy of the follow-up time in cohort studies remains open. Methods: The ON-SINT study is an observational, retrospective, nationwide, real-life cohort study, in which patients diagnosed with COPD were recruited between December 2011 and April 2013 by primary care (PC) and secondary care (SC) physicians. Patients were evaluated at the inclusion visit and at the initial visit when the diagnosis of COPD was first established. Distribution of lung function decline over the years was studied comparing those cases with longer follow-up times, with the median of the distribution as the cutoff point. Results: The sample included 1214 patients of which 857 (70.6%) were recruited by PC and 357 (29.4%) by SC physicians. Median follow-up time was 6.26 years. Mean annual change in the complete cohort were –4.5 (222) ml year–1 for FVC and 5.5 (134) ml year–1 for FEV1. We confirm the variable distribution of FEV1 decline and found that longer follow-up periods reduce this variability. Of note, FEV1 decline was different between groups (shorter: 19.7 [180.4] vs longer: –9.7 [46.9]; p = 0.018). Further, our data revealed differences in the clinical presentation according to follow-up times, with special emphasis on dyspnea (OR: 1.035; 95%CI: 1.014–1.056), exacerbations (OR 1.172; 95%CI 1.045–1.315) and CAT scores (OR 1.047; 95%CI 1.019–1.075) being associated with longer follow-up times. Conclusions: This study describes the impact of follow-up periods on lung function variability, and reveals differences in clinical presentation according to follow-up times, with special emphasis on dyspnea, exacerbations and CAT scores.

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Section: Discussioncontrasting

confidence: 67%

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

Lόpez-Campos

Fernández-Villar

Represas-Represas

et al. 2017

European Clinical Respiratory Journal

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“…These observations are in alignment with earlier published literature. 15,16,[28][29][30][31] Depression and anxiety are among the strongest predictors of impaired quality of life, 32 and anxiety among COPD patients can lead to the vicious cycle of breathlessness and anxiety known as "dyspnea-anxiety-dyspnea cycle," which means that patients' emotional response to breathlessness result in intensification of their perception of breathlessness. 33 Hence, it is very important for healthcare professionals to be knowledgeable of and take into account gender differences regarding comorbidities when managing patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study

Lisspers

Larsson

Janson

et al. 2019

npj Prim. Care Respir. Med.

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The present study aimed to generate real-world evidence regarding gender differences among chronic obstructive pulmonary disease (COPD) patients, especially as regards the diagnosis and outcomes in order to identify areas for improvement and management and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients and a matched reference population from 52 primary care centers in 2000-2014. The incidence of COPD, prevalence of asthma and other comorbidities, risk of exacerbations, mortality rate, COPD drug prescriptions, and healthcare resource utilization were analyzed. In total, 17,479 patients with COPD were included in the study. During the study period, COPD was more frequent among women (53.8%) and women with COPD experienced more exacerbations vs. men (6.66 vs. 4.66). However, the overall mortality rate was higher in men compared with women (45% vs. 38%), but no difference for mortality due to COPD was seen between genders over the study period. Women seemed to have a greater susceptibility to asthma, fractures, osteoporosis, rheumatoid arthritis, rhinitis, depression, and anxiety, but appeared less likely to have diabetes, kidney diseases, and cardiovascular diseases. Furthermore, women had a greater risk of COPD-related hospitalization and were likely to receive a significantly higher number of COPD drug prescriptions compared with men. These results support the need to reduce disease burden among women with COPD and highlight the role of healthcare professionals in primary care who should consider all these parameters in order to properly diagnose and treat women with COPD.

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“…Dyspnoea appears strongly associated with depression in women [34][35][36][37]. In France, a working group studying a real-life COPD patient population showed that, for a given age and level of airflow obstruction, women have a higher BODE index (body mass index, airflow obstruction, dyspnoea and exercise capacity) due to a lower body mass index and more pronounced dyspnoea, suggesting a poorer overall prognosis [38]. Considering the pulmonary hypertension phenotype in COPD, it is equally present in both sexes as shown by the ASPIRE register, whereas there is a female predominance in pulmonary hypertension in group one [39].…”

Section: Epidemiology Of Copd In Womenmentioning

confidence: 99%

Women and COPD: do we need more evidence?

et al. 2019

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@ERSpublicationsThe face of COPD is increasingly female. We need more evidence and a change in how the disease is managed.ABSTRACT The increasingly female face of chronic obstructive pulmonary disease (COPD) prevalence among women has equalled that of men since 2008, due in part to increased tobacco use among women worldwide and exposure to biomass fuels. This finding is supported by a number of characteristics. There is evidence of susceptibility to smoking and other airborne contaminants, along with epidemiological and phenotypic manifestations. COPD has thus become the leading cause of death in women in the USA. The clinical presentation is characterised by increasingly pronounced dyspnoea with a marked tendency towards anxiety and depression, undernutrition, nonsmall cell lung cancer (especially adenocarcinoma) and osteoporosis. Quality of life is also more significantly impacted. The theories advanced to explain these differences involve the role played by oestrogens, impaired gas exchange in the lungs and smoking habits. While these differences require appropriate therapeutic responses (smoking cessation, pulmonary rehabilitation, long-term oxygen therapy), barriers to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. Faced with this serious public health problem, we need to update and adapt our knowledge to the epidemiological changes.

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Impact of gender on COPD expression in a real-life cohort

Cited by 38 publications

References 15 publications

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study

Women and COPD: do we need more evidence?

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