Clinical Features Of Women With COPD: Sex Differences In A Cross-Sectional Study In Spain (“The ESPIRAL-ES Study”)

Abstract

Aim

This cross-sectional multicenter study was performed aimed at describing the clinical characteristics of women with COPD attended in routine daily practice in Spain.

Methods and results

Of a total of 1610 consecutive patients diagnosed with COPD recruited in primary care centers and pneumology services throughout Spain over a 90-day period, 17.9% (n=286) were women, with a median age of 62 years. Differences in COPD phenotypes by sex were statistically significant (P = 0.002). Males as compared with females showed a higher prevalence of non-exacerbator (47.9% vs 42.2%) and exacerbator with chronic bronchitis (22.9% vs 18.8%) phenotypes, whereas the ACOS phenotype was more common among females (21.7% vs 12.9%). The mean (SD) CAT score was similar in men than in women (20.8 [9.0] vs 21.2 [8.7], P = 0.481), as well as the impact of the disease on the quality of life according to CAT scores of <5 (no impact), 5–9 (low), 10–20 (medium), >20 (high), and >30 (very high). Sex-related differences according to smoking status were statistically significant (P < 0.001), with a higher percentage of men as compared with women in the groups of current smokers and ex-smokers; never-smokers were higher in women (9.1%) than in men (0.6%). The mean number of comorbidities was 2.01 (1.43) (95% CI 1.93–2.09) in males and 1.99 (1.42) (95% CI 1.83–2.16) (P = 0.930) in females, but cardiovascular diseases (hypertension, ischemic heart disease, chronic heart failure) were more frequent in men, whereas metabolic disorders (osteoporosis) were more frequent in women.

Conclusion

This study highlights the impact of COPD in women and the importance of continuing sex-based research in tobacco-related respiratory diseases.

Keywords:

• pulmonary disease
• chronic obstructive
• chronic bronchitis
• phenotype
• pulmonary emphysema
• quality of life
• asthma

Acknowledgments

The authors thank Marta Pulido, MD, PhD, for editing the manuscript and editorial assistance. This study was founded by Grupo Ferrer, Barcelona, Spain.

Disclosure

Dr Alcázar-Navarrete reports personal fees from GSK; grants, personal fees, and non-financial support from Novartis AG; personal fees and non-financial support from Boehringer Ingelheim and Chiesi; grants, personal fees, and non-financial support from Laboratorios Menarini; grants, personal fees, non-financial support from Laboratorios Ferrer; personal fees, non-financial support from Laboratorios Rovi; and personal fees from Gebro and Astra-Zeneca, outside the submitted work. In addition, Dr Alcázar-Navarrete has a patent P201730724 licensed. Ms Anna Campuzano and Joselín Pérez are full-time employees at Grupo Ferrer Internacional, Spain. The remaining authors report no conflicts of interest to be disclosed in this work.