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

{"title":"Body Mass Index and Bronchodilator Responsiveness in Adults: Analysis of 2 Population-Based Studies in 4 South American Countries.","authors":"Anderson N Soriano-Moreno, Andres G Lescano, Robert H Gilman, J Jaime Miranda, Antonio Bernabe-Ortiz, Adolfo Rubinstein, Laura Gutierrez, Vilma Irazola, Robert A Wise, William Checkley","doi":"10.15326/jcopdf.2025.0608","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0608","url":null,"abstract":"<p><strong>Introduction: </strong>In South America, the rise in chronic respiratory diseases and weight-related issues due to the ongoing epidemiological transition has prompted research into their interrelationship.</p><p><strong>Methods: </strong>We sought to assess the association between body mass index (BMI) and bronchodilator responsiveness (BDR) among adults in Peru, Chile, Uruguay, and Argentina, using population-based data from two cohort studies. We defined BDR as a ≥12% and ≥200 mL increase in either forced expiratory volume in one second (FEV₁) or forced vital capacity (FVC) after administration of a short-acting bronchodilator. The analysis also distinguished between FEV₁- and FVC-specific BDR. We used logistic regression adjusted for confounders to evaluate associations with BMI.</p><p><strong>Results: </strong>Among 7,160 participants (55.2% men, mean age 57.3 years), 23.7% had a BMI <25 kg/m² and 35.5% had a BMI ≥30 kg/m². Overall, 9.5% met the criteria for BDR; with 7.8% showing FEV₁-specific and 4.9% FVC-specific responses. Compared to a BMI of 20-24.9 kg/m², a BMI ≥30 kg/m² was associated with higher odds of FVC-specific BDR (adjusted OR = 1.47, 95% CI 1.08-2.03), whereas a BMI <20 kg/m² was associated with FEV₁-specific BDR among participants with asthma (6.34, 1.16-35.1) and chronic bronchitis (4.71, 1.28-15.9), and with higher odds of any BDR in those with chronic bronchitis (3.90, 1.19-11.93).</p><p><strong>Conclusion: </strong>There was a differential relationship between BMI and types of BDR: higher BMI was associated with FVC-specific responsiveness, whereas lower BMI was linked to FEV₁-specific BDR in individuals with asthma and chronic bronchitis and to overall BDR in those with chronic bronchitis.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228597","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":"Association of Mucus Plugging and Body Mass Index in Patients With Advanced COPD GOLD 3/4 With Emphysema.","authors":"Jacopo Saccomanno, Thomas Elgeti, Stephanie Spiegel, Eva Pappe, Thomas Sgarbossa, Antonia Petersen, Konrad Neumann, Marcus A Mall, Martin Witzenrath, Ralf-Harto Hübner","doi":"10.15326/jcopdf.2025.0617","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0617","url":null,"abstract":"<p><strong>Background: </strong>COPD is classified by its clinical phenotypes-chronic bronchitis and emphysema. A CT-based mucus plug score (MPS) was recently identified as a biomarker to subgroup COPD patients with increased airway mucus plugs. While not necessarily linked to more pronounced symptoms or structural lung changes, mucus plugs are associated with increased mortality. Interestingly, a higher MPS seems to be associated with a lower body mass index (BMI), likewise associated with increased mortality. This study aims to characterize patients with advanced lung emphysema presenting for lung volume reduction therapy with a special focus on mucus plug occurrence.</p><p><strong>Material and methods: </strong>This retrospective, monocentric study assessed MPS in advanced COPD (GOLD III/IV) and emphysema patients evaluated for lung volume reduction therapy at Charité-Universitätsmedizin Berlin. CT scans were analyzed for mucus plugging, and clinical data were obtained from the Lung Emphysema Registry (www.lungenemphysemregister.de).</p><p><strong>Results: </strong>A total of 127 CT scans were assessed for MPS. About 50% had no mucus plugs (score = 0), 25% had an intermediate burden (score 1-2), and 25% had a high burden (score ≥3). Higher MPS correlated with lower BMI, more pronounced emphysema, and worse lung function, including forced expiratory volume in 1 second, vital capacity, and diffusing capacity of carbon monoxide. Residual volume, pCO2, the 6-minute walk test, and quality-of-life parameters were unaffected. Multivariate regression analysis found a strong association between mucus plugs and BMI, showing that a decrease in BMI was associated with a higher mucus burden (p<0.001; coefficient of -1.584).</p><p><strong>Interpretation: </strong>This study supports an association between high MPS and BMI in a vulnerable subgroup of advanced COPD patients. Further research is needed to understand the pathophysiology and consequences of mucus plugs, aiming for individualized risk assessments and treatment strategies.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228614","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":"Tiotropium in Patients With Airflow Limitation According to the Fixed Ratio But Not the Lower Limit of Normal: A Secondary Analysis of the Tiotropium in Early-COPD Study.","authors":"Kunning Zhou, Fan Wu, Zhishan Deng, Qi Wan, Suying Huang, Nanshan Zhong, Yumin Zhou, Pixin Ran","doi":"10.15326/jcopdf.2025.0629","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0629","url":null,"abstract":"<p><strong>Background: </strong>Patients with airflow limitation according to the fixed ratio but not the lower limit of normal (LLN) (FR+LLN-) have a poorer respiratory prognosis and higher mortality than the normal fixed ratio. However, whether tiotropium treatment improves respiratory health outcomes in patients with FR+LLN- remains unclear.</p><p><strong>Methods: </strong>This was a secondary analysis of the 24-month Tie-COPD study, a multicentre, randomized, double-blind clinical trial comparing tiotropium with placebo for mild-to-moderate COPD. FR+LLN- was defined as a post-bronchodilator FEV₁/FVC ratio of <0.70 but ≥LLN. The primary endpoint was the between-group difference in the change from baseline to 24 months in pre-bronchodilator FEV₁. Key secondary endpoints included the between-group difference in the annual decline in pre-bronchodilator FEV₁ and exacerbations.</p><p><strong>Results: </strong>In the Tie-COPD study, 92 patients (12%) had FR+LLN-. Tiotropium resulted in a significantly higher pre-bronchodilator FEV₁ at 24 months (difference, 191 mL; 95% confidence interval [CI] 99, 283), with a least-squares mean (LSM) change from baseline of 47 mL (95% CI -13, 108) versus -140 mL (95% CI -215, -64) with placebo. The annual decline in the pre-bronchodilator FEV₁ was 24 mL/year with tiotropium and 89 mL/year with placebo (difference 60 mL/year; 95% CI 2, 118) from 30 days through 24 months. Tiotropium reduced total exacerbations compared with placebo (relative risk=0.50; 95% CI 0.27, 0.94).</p><p><strong>Conclusion: </strong>This study demonstrated tiotropium treatment improved lung function, ameliorated lung function decline, and reduced exacerbations compared with placebo in patients with FR+LLN-, providing evidence-based medicine evidence for the treatment in this population.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228610","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":"Sex-Associated Radiographic and Clinical Differences in Nontuberculous Mycobacteria Pulmonary Disease.","authors":"Bryan Garcia, Matthew Mullins, Lindsay Lim, German Henostroza, Camilla Margaroli","doi":"10.15326/jcopdf.2025.0622","DOIUrl":"https://doi.org/10.15326/jcopdf.2025.0622","url":null,"abstract":"<p><p>The incidence of infections caused by nontuberculous mycobacteria (NTM) are steadily increasing worldwide and the most common site of infection is the lung. Clinical characteristics of individuals with NTM pulmonary disease (NTM-PD) demonstrate pronounced geographical heterogeneity. In the United States, NTM-PD has an affinity for post-menopausal Caucasian females, many of whom are never-smokers, whereas in Asia NTM-PD is more common in males with post-tuberculosis lung disease. While these geographical differences are known on the global scale, it remains unclear whether radiographic sex-associated differences in NTM-PD are present within the US cohort. In this single center cross-sectional retrospective study of our patient registry, we sought to assess this knowledge gap by comparing radiographic and clinical features of individuals with NTM-PD by sex. We observed a significant preponderance of cavitary disease in men, while women commonly presented with bilateral apical fibrosis, increased nodules and tree-in-bud patterns in the lower lobes, and an increased risk of refractory disease and concomitant co-infection. Results from this study demonstrate several sex-associated differences in the radiographic phenotype of NTM-PD, and may be the result of differences in pre-existing risk factors that contribute to the development of NTM-PD. Future studies will be required to better assess the broad applicability of these findings to centers from other geographic regions where the underlying etiology of disease may vary.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228544","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":"Diagnosing Type 2 Inflammation in COPD: Comparison of Blood and Sputum Eosinophil Assessment in the University of California Los Angeles COPD Phenotyping Study.","authors":"W Blake LeMaster, Sarah A Ingersoll, Hyewon Phee, Renee Wen, Jing Bai, John A Belperio, Russell G Buhr, Jonathan E Phillips, Vyacheslav Palchevskiy, Tiffany Bina, Donald P Tashkin, Christopher B Cooper, Igor Z Barjaktarevic","doi":"10.15326/jcopdf.2024.0599","DOIUrl":"10.15326/jcopdf.2024.0599","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) phenotyping is an approach for developing tailored therapies. The eosinophilic phenotype is associated with exacerbation risk and response to specific treatments. This study evaluates the relationship between sputum and blood eosinophilia, hypothesizing that sputum eosinophil percentage (SpE%) better reflects disease severity and exacerbation risk than blood eosinophil counts (BEC).</p><p><strong>Methods: </strong>This was a single-center, prospective observational cohort with 107 participants aged 40-80 with clinically diagnosed COPD. Participants completed spirometry, a 6-minute walk test, and questionnaires, and blood and sputum samples were provided at baseline and 3 months. BEC and SpE% were measured via routine complete blood counts and flow cytometric analyses (fluorescence-activated cell sorting [FACS]). Eosinophilic phenotype thresholds were defined as BEC≥300 cells/μL and SpE%≥2%, and associations with clinical characteristics and outcomes were investigated.</p><p><strong>Results: </strong>Adequate sputum specimens were obtained less frequently than blood (60.7% versus 98%). SpE% showed poor repeatability (interclass coefficient 0.36) and poor correlation with FACS (Spearman's 𝜌=0.008, <i>p</i>=0.58). Conversely, BEC showed higher repeatability (𝜌=0.67, <i>p</i><0.01) and better correlation with FACS (𝜌=0.74, <i>p</i><0.01). More participants were classified as eosinophilic COPD by sputum (33.3%) than by blood (19.6%). BEC values were poorly correlated with SpE% (𝜌=0.13, <i>P</i>=0.39), and sputum and blood-based diagnostic criteria showed poor agreement (64.5%, Cohen's 𝜅 0.10). High SpE%, but not high BEC, was associated with lower forced expiratory volume in 1 second percentage predicted.</p><p><strong>Conclusions: </strong>In stable COPD patients, BEC and SpE% did not correlate well, and blood- and sputum-based diagnostic criteria identified different individuals. Defining eosinophilic COPD requires a better understanding of the bio-compartment sampled, testing methods, and cut-off values used.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"368-379"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800823","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":"Prospective COPD Case Finding in a Lung Cancer Screening Program: A Pilot Study.","authors":"Robert Spetrini, Paul Pikman, Vincent Kang, Jared Beaudin, Hana Rajevac, Karl Anderson, Nur Ay, Patrick Ottman, Katherine El-Tayeb, Lee Gazourian, Yuxiu Lei, Anthony Campagna, Richard Thomas, Batolome Celli, Victor Pinto-Plata","doi":"10.15326/jcopdf.2025.0636","DOIUrl":"10.15326/jcopdf.2025.0636","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) remains underdiagnosed and undertreated. Because screening asymptomatic individuals for COPD is not recommended, several case-finding tools have been explored. The COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE) questionnaire and peak expiratory flow (PEF) rate (CAPTURE tool) have been tested in the primary care setting, with disappointing results. We hypothesized that these tools could yield better results in a computed tomography lung screening (CTLS) program, where individuals have a history of cigarette smoking and higher prevalence of COPD.</p><p><strong>Methods: </strong>We recruited 67 patients referred to a CTLS program at a single institution. Participants completed the CAPTURE and COPD Assessment Test (CAT) questionnaires. Spirometric testing was completed with a portable device and low-dose chest computed tomography (CT) was performed according to a standard protocol.</p><p><strong>Results: </strong>The group's mean age was 66 ±7 years, 43% were male, with a 37 pack-year smoking history. Eighteen (27%) had COPD (forced expiratory volume in 1 second of 60 ±22% predicted) and a higher CAT score (12 [interquartile range (IQR) 6-15]) compared to the nonobstructed group (CAT=7 [IQR 3-10]), <i>p</i><0.02. Combining the CAPTURE questionnaire with PEF generated the best COPD diagnostic criteria (sensitivity=0.82, specificity=0.73, area under the receiver operating curve [AUROC]=0.784), followed by combining the CAPTURE questionnaire and emphysema presence (sensitivity=0.73, specificity=0.71, AUROC=0.779). The CAPTURE questionnaire alone had a sensitivity=0.766, specificity=0.616, and AUROC=0.669.</p><p><strong>Conclusions: </strong>The CAPTURE tool is an effective method to find COPD cases in lung cancer screenings. A CT diagnosis of emphysema can substitute peak flow in this population.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"411-418"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977936","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":"Low Lung Function in Middle-Aged Smokers Impacts Health Status, Morbidities, and Mortality: An Observational Analysis of the Lovelace Smokers Cohort.","authors":"Yohannes Tesfaigzi, Mary N Brown, Congjian Liu, François-Xavier Blé, Darlene Harbour, Steven A Belinsky, Maria A Picchi, Ventzislava A Hristova, Kristoffer Ostridge, Mehul Patel, Paul Dorinksky, Bartolome R Celli","doi":"10.15326/jcopdf.2025.0605","DOIUrl":"10.15326/jcopdf.2025.0605","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary function tests may predict future outcomes; however, they are not often performed in middle-aged individuals at risk for future airway obstruction. We examined whether smokers with low lung function (LLF) have an increased risk of developing health problems and mortality over time.</p><p><strong>Methods: </strong>Current and ever smokers (n=830) from the Lovelace Cohort aged 40-60 years without baseline airway obstruction and with at least 2 spirometry measurements over 18 months were included. Participants were divided into high lung function (HLF) and LLF function tertiles based on forced expiratory volume in 1 second percentage predicted (FEV₁%pred). Lung function, health status, and comorbidities were compared at baseline and over 17 years; mortality at 17 years was also assessed. From these participants, 61 HLF (baseline FEV1%pred >99%) and 26 LLF (baseline FEV1%pred <88%) were examined at 17 years follow-up using logistic regression.</p><p><strong>Results: </strong>Baseline demographic and clinical characteristics were generally similar between the LLF and HLF tertiles, except for age, sex, body mass index, and lung function. In the overall cohort (LLF, n=277; HLF, n=277), survival of the HLF versus LLF cohort showed a hazard ratio of 0.49 (<i>p</i>=0.02). At the 17-year follow-up, LLF was associated with increased prevalence of wheeze, cardiovascular diseases, chronic lung diseases, diabetes, and worse health status.</p><p><strong>Conclusions: </strong>Smokers with LLF without airflow obstruction exhibited reduced survival and an increased risk for development of chronic morbidities. Thus, spirometry may be used to identify at-risk individuals, allowing for early preventative interventions that can improve long-term health outcomes. <i>Take home message:</i> Among ever smokers without airflow obstruction, LLF is associated with increased mortality and poor health status. Spirometry may identify at-risk patients, enabling early emphasis on interventions with the potential to improve long-term health outcomes.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"357-367"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800852","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":"Genetic Evidence for Causal Relationships Between Circulating Cathepsin Levels and Chronic Obstructive Pulmonary Disease: A Mendelian Randomization Study.","authors":"Chao Duan, Ao Zhang, Suyan Tian","doi":"10.15326/jcopdf.2025.0626","DOIUrl":"10.15326/jcopdf.2025.0626","url":null,"abstract":"<p><strong>Background: </strong>Cathepsins, a family of lysosomal proteolytic enzymes, have been implicated in the pathogenesis of various complex diseases, including chronic obstructive pulmonary disease (COPD). However, the causal relationship between cathepsins and COPD remains unclear.</p><p><strong>Methods: </strong>This study employed Mendelian randomization (MR) to investigate the potential causal effects of cathepsin levels on COPD risk. This MR analysis utilized genetic data from individuals of European ancestry in the INTERVAL study and FinnGen consortium. Specifically, summary-level genetic data for 9 cathepsins (B, E, F, G, H, O, L2, S, and Z) were obtained from the INTERVAL study, while COPD summary statistics were sourced from the FinnGen consortium. We conducted comprehensive MR analyses, including univariable MR, reverse MR, multivariable MR (MVMR), and MR least absolute shrinkage and selection operator, to assess causal relationships between cathepsin levels and COPD risk.</p><p><strong>Results: </strong>Univariable MR analysis revealed no significant causal relationships (forward or reverse) between the 9 cathepsins and COPD risk. However, MVMR analysis identified cathepsins O and S as having direct causal effects on COPD. For cathepsins O and S, odds ratio was estimated as 1.130 (<i>p</i>=0.022, 95% confidence interval [CI] = 1.018-1.255) and 1.068 (<i>p</i>=0.025, 95% CI = 1.008-1.132), respectively. Furthermore, these 2 cathepsins were independent risk factors for COPD after adjusting for smoking.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first MR study to systematically evaluate the causal role of cathepsins in COPD. Further research, particularly clinical trials, is warranted to validate these associations and explore the therapeutic potential of targeting cathepsins in COPD management.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"380-389"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800850","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":"Improving Research for COPD in Rural Areas: A Statement from the COPD Foundation Medical and Scientific Advisory Committee.","authors":"Maura E Thornton, David M Mannino, Jill A Ohar, Nirupama Putcha, Paul F Simonelli, Mark T Dransfield, M Bradley Drummond","doi":"10.15326/jcopdf.2025.0618","DOIUrl":"10.15326/jcopdf.2025.0618","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) among individuals living in rural areas is associated with worse health outcomes. New strategies are needed to study interventions and deliver proven therapies to people with COPD in rural areas. This statement from the COPD Foundation Medical and Scientific Advisory Committee highlights specific challenges in capturing the key characteristics of rural residents and identifies approaches to improve research for COPD in rural areas. Specifically, geographic isolation, access to specialist care, lack of broadband access, and complex tobacco and exposure histories are drivers of COPD health disparities in rural populations that are not captured by conventional definitions of rurality. To improve the design of research studies among people with COPD living in rural settings, certain actions are identified. These include the inclusion of specific covariates such as distance and travel time to health care services and multidimensional assessment tools for societal and individual health determinants in data collection; deploying qualitative and mixed-methods research designs to assess cultural differences driving health care access and health behaviors; decentralized carousel recruitment models in study design; and operationalizing research partnerships to improve support for primary care providers engaged in research. These approaches will permit robust assessment of the complex matrices driving disparate health outcomes among people with COPD in rural areas.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"419-425"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800851","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":"Navigating COPD and Bronchiectasis: A COPD Foundation Survey of Differences in Patient-Perceived Health Care Experiences by Sex.","authors":"Radmila Choate, Timothy R Aksamit, John Torrence, Phyliss A DiLorenzo, Arturo Rodriguez, Bruce Miller, Jean Wright, Dawn L DeMeo","doi":"10.15326/jcopdf.2025.0620","DOIUrl":"10.15326/jcopdf.2025.0620","url":null,"abstract":"<p><strong>Rationale: </strong>Chronic lung diseases, including chronic obstructive pulmonary disease (COPD) and bronchiectasis (BE), may differ by sex in symptom onset, diagnostic delays, and disease burden. This study examined health care experiences and symptom burden among individuals with self-reported COPD, BE, or nontuberculous mycobacteria (NTM).</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from an online survey of U.S. and international participants with self-reported COPD, BE, or NTM, recruited via COPD Foundation social media. The questionnaire, developed with input from COPD Foundation leadership, physician-researchers, and patient stakeholders, assessed health care experiences, disease burden, and symptoms. A subset of women answered menopause-related questions. Descriptive statistics were compared by sex and disease group: COPD (with/without BE or NTM) and BE (with/without NTM). T-tests assessed continuous variables; Chi-square or Fisher's exact tests analyzed categorical variables.</p><p><strong>Results: </strong>Among 632 respondents (mean age 70±9 years, 74% women), 68% reported COPD and 32% BE. Women with COPD were younger (<i>p</i>=0.048) and sought care sooner after symptom onset (<i>p</i><0.010) than men. More women with COPD did not have their diagnosis explained by a health care provider (<i>p</i>=0.038) and reported diagnosis-related anxiety, depression, or fear (<i>p</i>=0.007). Among participants with BE, men were more likely to receive a confirmed diagnosis sooner (<i>p</i>=0.038) and during hospitalization (<i>p</i>=0.024). Disease management burden, pulmonologist visit frequency, Chronic Airways Assessment Test scores, numbers of comorbidities, and financial burden were similar across groups. Over 75% of women were postmenopausal, and one-third reported worsened pulmonary symptoms postmenopause.</p><p><strong>Conclusions: </strong>Differences in diagnostic delays and symptom burden highlight the need for further research into health care disparities to improve pulmonary care and outcomes.</p>","PeriodicalId":51340,"journal":{"name":"Chronic Obstructive Pulmonary Diseases-Journal of the Copd Foundation","volume":" ","pages":"399-410"},"PeriodicalIF":2.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800853","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}