Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation最新文献

{"title":"Outcomes of Virtual Pulmonary Rehabilitation in Oxygen-Dependent COPD Patients.","authors":"Hector Filizola, Anirudh Kumar, Russell G Buhr, Kristin Schwab Jensen","doi":"10.15326/jcopdf.2024.0572","DOIUrl":"10.15326/jcopdf.2024.0572","url":null,"abstract":"<p><p>Virtual pulmonary rehabilitation (PR) is a proven yet underutilized intervention in COPD patients. However, the safety nor the effectiveness of virtual PR is established for patients with advanced disease and higher disease severity, particularly those requiring supplemental oxygen. We performed a retrospective review of 167 patients to evaluate the feasibility, safety, and effectiveness of virtual PR in oxygen-dependent versus non-oxygen-dependent COPD patients. Our primary outcome, attendance was high (88% of sessions were attended by both groups). Adverse events occurred in only 2 (1%) participants, 1 in each group. Both groups showed significant post-intervention improvements in dyspnea and depression scores (CAT, mMRC, PHQ-9) and functional exercise capacity (1MSTS), with the improvements approaching or exceeding the established minimal clinically important difference (MCID) values. When comparing the oxygen-dependent and non-oxygen groups, there were no significant differences in the degree of improvement for CAT, PHQ-9, and 1MSTS. For mMRC, those on oxygen did improve by 0.3 less than those not on oxygen (P=0.052). These findings suggest virtual PR is safe and effective for COPD patients requiring oxygen. To our knowledge, this is the first study to compare outcomes of virtual PR in patients on and off oxygen. Future research should explore patient-specific factors that can further individualize care.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease Onset and Burden in Patients With Chronic Bronchitis and COPD: A Real-World Evidence Study.","authors":"Jamuna K Krishnan, Gerard J Criner, Bilal H Lashari, Fernando J Martinez, Victor Kim, Arthur Lindoulsi, Edward Khokhlovich, Pablo Altman, Helene Karcher, Matthias Schoenberger","doi":"10.15326/jcopdf.2024.0565","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0565","url":null,"abstract":"<p><p>Chronic bronchitis (CB), classically defined as having cough and sputum production for at least three months per year for two consecutive years, is frequently associated with COPD. This retrospective cohort study using the Optum® de-identified Electronic Health Record data set (Optum® EHR) aimed to identify patients with CB, COPD and both CB and COPD through application of the classical definition of CB, and to compare the characteristics of these populations, timing of diagnosis as well as their healthcare resource utilization (HCRU). Scanning of the EHRs was performed electronically using a specially developed algorithm. Of 104,633,876 patients in the study period between January 2007 to September 2020, 628,545 patients had CB only (i.e., non-obstructive disease),129,084 had COPD only (COPD cohort) and 77,749 had both COPD and CB (COPD-CB cohort). 75.9% of patients (59,009/77,749) fulfilled the criteria for CB diagnosis before their first diagnosis with COPD, compared with 24.1% who had COPD before being diagnosed with CB. HCRU over five years was highest in the COPD-CB cohort, whereas the COPD cohort and CB cohorts had similar HCRU over five years. The COPD-CB cohort had a greater percentage of common COPD comorbidities and exposure to more drug classes than the other cohorts. These results highlight the importance of increased attention to CB. CB often precedes the diagnosis of COPD and subsequently leads to high HCRU. Interventions to better manage CB and prevent progression of CB to COPD could improve morbidity in this population.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Stress is Associated with Health Outcomes, Platelet Activation, and Oxidative Stress in COPD.","authors":"Obiageli Offor, Michelle N Eakin, Han Woo, Daniel Belz, Marlene Williams, Sarath Raju, Meredith McCormack, Nadia N Hansel, Nirupama Putcha, Ashraf Fawzy","doi":"10.15326/jcopdf.2024.0561","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0561","url":null,"abstract":"<p><strong>Background: </strong>Individuals with COPD are disproportionately affected by social determinants of health that have been associated with worse respiratory outcomes. This study evaluates the association of perceived stress with respiratory outcomes and distinct biologic mechanisms among former smokers with COPD.</p><p><strong>Methods: </strong>Participants were assessed in an observational study at baseline, 3-months, and 6-months. Questionnaires assessed perceived stress (Perceived Stress Scale, PSS), respiratory symptoms and incidence of COPD exacerbations. Generalized linear mixed models evaluated the association of PSS score with COPD outcomes and biomarkers of platelet activation (urine 11-dehydro-thromboxane B2 [11dTxB2]), oxidative stress (urine thiobarbituric acid reactive substances [TBARS], 8- hydroxydeoxyguanosine [8-OHdG], and 8-isoprostane), and inflammation.</p><p><strong>Results: </strong>Among 99 participants, the median PSS score was 13 (IQR 8-18) across all visits. Compared with low perceived stress (PSS 0-13), moderate [PSS 14-26] and high perceived stress (PSS 27-40) were associated with worse respiratory health status and respiratory-related quality of life, with point estimates for high perceived stress exceeding clinically important differences. Only high PSS was associated with increased moderate/severe exacerbations (odds ratio 4.15, 95%CI: 1.28-13.47). Compared to low stress, high stress was associated with lower TBARS (β=-25.5%, 95%CI: -43.8- -1.2%), higher 8-isoprostane (β=40.1%, 95%CI: 11.5-76.0%). Among individuals with mild-moderate COPD, compared to low stress, moderate (β=20.1%, 95%CI: 3.1-40.0%) and high (β=52.9%, 95%CI: 22.1-91.6%) stress were associated with higher 11dTxB2.</p><p><strong>Conclusion: </strong>Among former smokers with COPD, higher perceived stress is associated with worse respiratory outcomes. Platelet activation and oxidative stress may be biologic pathways through which perceived stress plays a role in COPD.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalized Non-Tuberculous Mycobacterial Pulmonary Disease Patients and Their Outcomes in the United States: A Retrospective Study Using National Inpatient Sample Data.","authors":"Saqib H Baig, Shruti Sirapu, Jesse Johnson","doi":"10.15326/jcopdf.2024.0568","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0568","url":null,"abstract":"<p><strong>Background: </strong>Non-tuberculous mycobacteria pulmonary disease (NTM-PD) is an emerging public health concern with increasing incidence and prevalence. Despite its chronic and progressive nature, there is a notable gap in research on the factors influencing hospital outcomes in this patient population.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study using data from the National Inpatient Sample (NIS) to analyze hospitalizations of adult patients diagnosed with NTM-PD. We examined patient demographics, comorbidities, and hospital characteristics to identify predictors of hospital length of stay (LOS) and discharge disposition. Multivariate negative binomial regression and logistic regression models were employed to assess the impact of these variables.</p><p><strong>Results: </strong>The study included 1,167 hospitalized NTM-PD patients, with a mean age of 66.9 years. The overall mean LOS was 7.4 days, with an average hospital cost of $15,606. Discharge to a nursing home was associated with a 78% longer LOS (IRR=1.78, p<0.0001). Key predictors of extended LOS included male gender, private insurance status, higher comorbidity burden, and increased number of procedures. Patients discharged to nursing homes were more likely to be older males with complex medical profiles. Interestingly, conditions such as malignancy and COPD, while linked to longer LOS, were associated with a decreased likelihood of discharge to a nursing home.</p><p><strong>Conclusion: </strong>Our study highlights significant predictors of LOS and discharge outcomes in NTM-PD patients, emphasizing the need for personalized and proactive management. These findings underscore the importance of targeted interventions in the outpatient setting to reduce hospital admissions and improve patient outcomes.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal and Validation of the Minimum Clinically Important Difference in Emphysema Progression.","authors":"Emily S Y Ho, Paul R Ellis, Diana Kavanagh, Deepak Subramanian, Robert A Stockley, Alice M Turner","doi":"10.15326/jcopdf.2024.0511","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0511","url":null,"abstract":"<p><strong>Objective: </strong>The severity of emphysema may be measured by lung density on CT scanning, and in alpha-1 antitrypsin deficiency (AATD) this measure has been used as the primary outcome in trials of disease modifying therapy, namely augmentation. However, the minimum clinically important difference (MCID) in lung density change is not known; this study aimed to derive and validate MCIDs for density values in AATD.</p><p><strong>Methods: </strong>The distribution method and anchoring density against FEV1 was used to derive mean and 95% confidence intervals for the MCID. Data from systematic reviews of CT density measurement and therapy for AATD obtained both absolute and annual change in lung density. Using the range of potential MCID generated by these methods, a value was chosen for validation against mortality, lung function and health status in the Birmingham (UK) AATD cohort, using regression to adjust for confounders.</p><p><strong>Results: </strong>Anchor and distribution methods generated a probable MCID of -1.87 g/L/year (range -1.53 to -2.20). The greatest differences between groups were found at the -2.2g/L/year with a greater FEV1 decline in individuals with greater lung loss. Absolute lung density change had a probable MCID of -2.04g/L (range -1.83 to -2.30), and there was a difference in lung function (p<0.001) and mortality; where individuals whose absolute lung loss of more than -2.04g/L had a greater risk of death (p<0.05).</p><p><strong>Interpretation: </strong>From initial evidence, we have shown absolute lung density change as a potential outcome for emphysema modifying therapies in AATD than annual density change, with an MCID of -2.04g/L.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Recording in Electronic Health Records: A Systematic Review.","authors":"Elizabeth Moore, Philip Stone, Ayda Alizadeh, Jaspreet Sangha, Saranya Das, Shraddha Arshanapalli, Jennifer K Quint","doi":"10.15326/jcopdf.2024.0577","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0577","url":null,"abstract":"<p><strong>Objective: </strong>Acute exacerbations of COPD (AECOPD) can have severe impacts on patients with the disease and a heavy burden on healthcare resources. Electronic health records (EHRs) are a valuable resource for identifying cases of AECOPD and research. Studies have attempted to validate case definitions of AECOPD and this review aimed to summarise validated AECOPD definitions in EHRs, and to provide guidance on the best algorithms to use to ensure accurate cohorts of AECOPD cases are available for researchers using EHRs.</p><p><strong>Methods: </strong>MEDLINE and Embase were searched and studies that met the inclusion criteria were reviewed by ≥2 reviewers. Data extracted included the algorithms used to identify AECOPD, the reference standards used to compare against the algorithm, and measures of validity. The risk of bias was assessed using QUADAS-2 adapted for this review.</p><p><strong>Results: </strong>Out of 2,784 studies found by the search strategy, 12 met the inclusion criteria. The clinical terminology used to build algorithms to detect AECOPD included codes from the International Statistical Classification of Diseases and Related Health Problems (ICD) 9^th and 10^th editions (ICD-9 and ICD-10), along with Read codes from UK general practices. AECOPD can be identified within EHRs using validated definitions, however the validity of AECOPD definitions vary considerably depending on the algorithm used and the settings they are applied in.</p><p><strong>Conclusion: </strong>Although there are validated definitions that can be used to identify AECOPD, there is no clear consensus on which provides the highest validity or the most sensitive and specific definition to use.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Nomogram for Predicting the Risk of Acute Heart Failure in Intensive Care Unit Patients with COPD.","authors":"Ziyang Wu, Sutong Zhan, Dong Wang, Chengchun Tang","doi":"10.15326/jcopdf.2024.0562","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0562","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to construct a prediction model to assess the onset of acute heart failure (AHF) in patients with chronic obstructive pulmonary disease (COPD) without history of heart failure and to evaluate the predictive value of the nomogram.</p><p><strong>Methods: </strong>This study involved 3,730 patients with COPD and no history of heart failure. Clinical and laboratory data were collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The patients were divided into a training set (2,611 cases) and a validation set (1,119 cases) in a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression was used to identify potential risk factors for AHF in patients with COPD. These factors were then subjected to multivariate logistic regression analysis to develop a prediction model for the risk of AHF. The model's differentiation, consistency, and clinical applicability were evaluated using receiver operating characteristic (ROC) analysis, a calibration curve, and decision curve analysis (DCA), respectively.</p><p><strong>Results: </strong>LASSO regression identified 10 potential predictors. The concordance index was 0.820. The areas under the curves for the training and validation sets were 0.8195 and 0.8035, respectively. The calibration curve demonstrated strong concordance between the nomogram's predictions and the actual outcomes. DCA confirmed the clinical applicability of the nomogram.</p><p><strong>Conclusion: </strong>Our nomogram is a reliable and convenient tool for predicting acute heart failure in patients with chronic obstructive pulmonary disease.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications of <i>Pseudomonas Aeruginosa</i> Colonization in Chronic Obstructive Pulmonary Disease Patients.","authors":"Wang Chun Kwok, Terence Chi Chun Tam, Chi Hung Chau, Fai Man Lam, James Chung Man Ho","doi":"10.15326/jcopdf.2024.0582","DOIUrl":"https://doi.org/10.15326/jcopdf.2024.0582","url":null,"abstract":"<p><strong>Background: </strong><i>Pseudomonas aeruginosa</i> is an important pathogen in patients with chronic respiratory diseases. It can colonize the airway and could have prognostic value in bronchiectasis and cystic fibrosis. Its role in chronic obstructive pulmonary disease (COPD) is less well defined.</p><p><strong>Methods: </strong>A prospective study was conducted in Hong Kong to investigate the possible association between <i>Pseudomonas aeruginosa</i> colonization and acute exacerbation of COPD (AECOPD) risks.</p><p><strong>Results: </strong>Among 327 Chinese patients with COPD included, 33 (10.1%) of the patients had <i>Pseudomonas aeruginosa</i> colonization. Patients with or without <i>Pseudomonas aeruginosa</i> colonization had similar background characteristics. Patients with <i>Pseudomonas aeruginosa</i> colonization had increased risks of moderate to severe AECOPD, severe AECOPD and pneumonia with adjusted odds ratio (aOR) of 3.15 (95% CI 1.05 - 9.48, p = 0.042), 2.59 (95% CI 1.01 - 6.64, p = 0.048) and 4.19 (95% CI 1.40 - 12.54, p = 0.011) respectively. Patients with <i>Pseudomonas aeruginosa</i> colonization also had increased annual frequency of moderate to severe AECOPD, median 0 [0 - 0.93] in the non-<i>Pseudomonas aeruginosa</i> colonization group and 1.35 [0 - 3.39] in the <i>Pseudomonas aeruginosa</i> colonization group, with a p-value of 0.005 in multi-variate linear regression.</p><p><strong>Conclusion: </strong><i>Pseudomonas aeruginosa</i> colonization is a potential independent risk factor for moderate to severe AECOPD and pneumonia among patients with COPD without co-existing bronchiectasis.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telerehabilitation Services Remain Increased Post-COVID-19 in Australia.","authors":"Anthony K May, Anne E Holland, Jennifer A Alison, Kelcie Herrmann, Narelle S Cox","doi":"10.15326/jcopdf.2024.0575","DOIUrl":"10.15326/jcopdf.2024.0575","url":null,"abstract":"","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"93-97"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KF4 Anti-Chymotrypsin-like Elastase 1 Antibody and Purified Alpha-1 Antitrypsin Have Similar but Not Additive Efficacy in Preventing Emphysema in Murine Alpha-1 Antitrypsin Deficiency.","authors":"Andrew J Devine, Noah J Smith, Rashika Joshi, Brandon Brooks-Patton, Jenna Dunham, Ansley N Varisco, Emily M Goodman, Qiang Fan, Basilia Zingarelli, Brian M Varisco","doi":"10.15326/jcopdf.2024.0535","DOIUrl":"10.15326/jcopdf.2024.0535","url":null,"abstract":"<p><strong>Background: </strong>Alpha-1 antitrypsin (AAT) deficiency is the most common genetic cause of emphysema. Chymotrypsin-like elastase 1 (CELA1) is a serine protease neutralized by AAT and is important in emphysema progression. <i>Cela1</i>-deficiency is protective in murine models of AAT-deficient emphysema. KF4 anti-CELA1 antibody prevented emphysema in porcine pancreatic elastase (PPE) and cigarette smoke models in wild-type mice.</p><p><strong>Methods: </strong>We evaluated potential toxicities of KF4 and its ability to prevent emphysema in AAT deficiency. We found Cela1 protein expression in mouse lungs, pancreas, small intestine, spleen, and bone marrow. In toxicity studies, mice treated with KF4 25mg/kg weekly for 4 weeks showed an elevation in blood urea nitrogen and slower weight gain compared to lower doses or equivalent dose immunoglobin G (IgG). By histologic grading of tissue injury of the lung, kidney, liver, and heart, there was some evidence of liver injury with KF4 25mg/kg, but in all tissues, injury was less than in control mice subjected to cecal ligation and puncture. In efficacy studies, KF4 doses as low as 0.5mg/kg reduced the lung elastase activity of <i>AAT^-/-</i> mice treated with 0.2 units of PPE.</p><p><strong>Results: </strong>In this injury model, <i>AAT^-/-</i> mice treated with KF4 1mg/kg weekly, human purified AAT 60mg/kg weekly, and combined KF4 and AAT treatment had less emphysema than mice treated with IgG 1mg/kg weekly. However, the efficacy of KF4, AAT, or KF4 and AAT was similar.</p><p><strong>Conclusion: </strong>While KF4 might be an alternative to AAT replacement, combined KF4 and AAT replacement does not confer additional benefit.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"12-22"},"PeriodicalIF":2.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}