Currently Viewing:
Currently Reading
ADA 2018 Standards Address Drugs With CV Benefits, Hold Firm on Blood Pressure
December 10, 2017 – Mary Caffrey
UC San Diego Researchers Receive $600,000 Grant to Test PI3Ky Inhibitor
December 08, 2017 – Kelly Davio
5 Approvals and Updates From the FDA This Week
December 08, 2017 – Jaime Rosenberg
AJMC® in the Press, December 8, 2017
December 08, 2017 – AJMC Staff
What We're Reading: Drug Imports; Insurers See ACA Profits; Alzheimer's Forecast
December 08, 2017 – AJMC Staff
This Week in Managed Care: December 8, 2017
December 08, 2017
Company Says It Will Seek FDA Approval for Video Game to Treat ADHD
December 07, 2017 – Allison Inserro
After Years of Research Into Dissatisfaction With Quality Measures, Is CMS Listening?
December 07, 2017 – Allison Inserro
Ribociclib Plus Oral Endocrine Partner Shows Efficacy in Women With HR+/HER2- Breast Cancer
December 07, 2017 – Jaime Rosenberg

Long-Term Oxygen Therapy Can Improve Survival in Patients With Oxygen-Dependent COPD

Surabhi Dangi-Garimella, PhD
A new study has shown that long-term oxygen therapy in patients with severe alpha-1 antitrypsin deficiency can improve survival; however, their outcomes do not improve following lung-transplantation.
Patients with severe alpha-1 antitrypsin deficiency (AATD) are at an increased risk of developing chronic obstructive pulmonary disease (COPD). Now, a new study has shown that long-term oxygen therapy (LTOT) in this patient population can improve survival; however, their outcomes do not improve following lung-transplantation.

Found in 1% to 2% of patients with COPD, the PiZZ phenotype, which is characteristic of AATD, is a significant cause for COPD. Along with vaccinations, bronchodilators, rehabilitation, and surgical interventions in selected patients, LTOT is also a treatment option.

In the current study, published in the International Journal of COPD, 14,644 patients who were on LTOT due to their COPD were enrolled. Patients with AATD, the authors note, tended to be younger, male, and never smokers. The study used data from the Swedish National Registry for Respiratory Failure for the period between January 1, 1987, and June 30, 2015.

At a median follow-up of 1.6 years on LTOT, patients without severe AATD had higher mortality (hazard ratio [HR] 1.53; 95% CI, 1.24–1.88)—there were 201 (71%) deaths among patients with AATD and 12,354 (86%) deaths among patients without AATD. The median survival was 1.9 years (95% CI, 1.8–1.9) overall; patients with AATD had a significantly longer survival (3.5 years; 95% CI, 2.8–4.3) than patients without AATD (1.9 years; 95% CI, 1.8–1.9; P<.001). This was after normalizing for age, gender, smoking status, body mass index, performance status, level of hypoxemia, and comorbidities. Cardiovascular deaths were higher in patients without AATD (16% compared with 6%; P<.001).

Of the 171 patients who underwent a lung transplant during the follow-up period, 53 (31%) had severe AATD. At a 4.4 year median follow-up after a lung transplant, 103 patients died, 36 (35%) of whom had severe AATD. While a higher proportion of AATD patients had a lung transplant—19%, compared with 1% of those without AATD—survival was similar for both populations. Higher age, according to the authors, was the only significant predictor of death after a lung transplant in this population.

Based on their findings, the authors conclude that patients with severe AATD have better survival in oxygen-dependent COPD, but prognosis following a lung transplant is independent of their AATD status.


Ekstrom M, Tanash H. Lung transplantation and survival outcomes in patients with oxygen-dependent COPD with regard to their alpha-1 antitrypsin deficiency status. Int J COPD. 2017;12: 3281-3287.

Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
Welcome the the new and improved, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up

Sign In

Not a member? Sign up now!