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March 2014, Vol 145, No. 3_MeetingAbstracts
Obstructive Lung Diseases | March 2014
Clinical Differences Between PatientsWith COPD Due to Biomass
Smoke orTobacco
Pilar Sanjun, MD; Rafael Golpe, PhD; Luis Prez-de-LLano, PhD;
Esteban Cano,MD; Olalla Castro-Aon, MDHospital Universitario Lucus
Augusti, Lugo, Spain
Chest. 2014;145(3_MeetingAbstracts):421A.
doi:10.1378/chest.1808632
Abstract
SESSION TITLE: COPD II
SESSION TYPE: Slide Presentations
PRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:00 AM
PURPOSE: Biomass smoke exposure is a risk factor for developing
chronicobstructive pulmonary disease (COPD). Little is currently
known concerning clinicaldifferences between COPD due to tobacco
and to biomass smoke. The purpose of thisstudy was to search for
clinical differences between both types of disease
METHODS: Retrospective observational study of 499 patients
diagnosed of COPDdue to tobacco or to biomass smoke exposure. Both
groups were compared regardingthe prevalence of several predefined
clinical phenotypes, severity of the diseasemeasured using several
markers, and weight of comorbidities assessed using theCharlson and
the COTE indices
RESULTS: Three hundred and seventy seven patients (75.5%) were
included in thetobacco group and 122 (24.4%) in the biomass group.
There were more males in thetobacco group (91.2% vs 41.8%, p <
0.0001) and patients were younger in this group(70.6 vs 76.2 years,
p < 0.0001). More patients were classified in GOLD B stage(29.5%
vs 13.5%, p = 0.0001) and less in GOLD D stage (32.8% vs 46.4%, p =
0.01)in the biomass group than in the tobacco group. BODEX values
were lower in the
biomass group. The COPD-plus-asthma phenotype was more prevalent
in the biomassgroup (21.3% vs 5%, p < 0.0001), although this
difference disappeared on adjustmentfor sex. The emphysema
phenotype was more frequent in the tobacco group (45.9%
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vs 31.9%, p = 0.009). The chronic bronchitis and frequent
exacerbator phenotypeswere similarly distributed between both
groups. The weight of comorbidities and therate of hospital
admissions were also similar between the biomass and tobacco
groups
CONCLUSIONS: There are several clinical differences between
patients with
COPD due to tobacco and to biomass smoke exposure, although some
of them mightbe partially attributable to sex differences between
both groups
CLINICAL IMPLICATIONS: The fact that COPD due to biomass smoke
has adifferent clinical presentation suggests that the natural
history, the rate of progressionand the inflammatory pattern might
be different to COPD due to tobacco. This factmight have
therapeutic implications. Further studies should be carried out to
clarifythis point
DISCLOSURE: Pilar Sanjun: Consultant fee, speaker bureau,
advisory committee,etc.: Almirall, Astra-Zeneca,
Boehringer-Ingelheim Rafael Golpe: Consultant fee,
speaker bureau, advisory committee, etc.: Novartis, GSK,
Astra-Zeneca, Boehringer-Ingelheim, Almirall Luis Prez-de-LLano:
Grant monies (from industry relatedsources): Almirall, Consultant
fee, speaker bureau, advisory committee, etc.:Almirall, Novertis,
Astra-Zeneca, Boehringer-Ingelheim, GSK, Menarini EstebanCano:
Consultant fee, speaker bureau, advisory committee, etc.: GSK
Olalla Castro-Aon: Consultant fee, speaker bureau, advisory
committee, etc.: Novartis
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