Swedish Study Finds "Closing Gap" of COPD Prevalence in Both Genders

A recently published study amassed real-world evidence from patients with chronic obstructive pulmonary disease (COPD), concluding that “there has been a closing of the gap in COPD prevalence among both genders.”

The retrospective cohort study conducted in Sweden collected data from over 17,000 patients with COPD registered in 52 primary care centers from 2000 to 2014. Eligible patients were matched with 84,455 age- and gender-matched controls.

COPD is the third leading cause of death globally, accounting for 3 million deaths annually. Previous studies conducted on the disease found COPD to be more prevalent in women.

The researchers cite another study conducted in Sweden that concluded, “COPD mortality among women increased during 1999-2009, and life expectancy in the COPD population was 9.4 years lower for women (vs 7.4 years lower in men) compared with that of the average Swedish population.”

In addition, mortality among women due to the disease is higher than that of many commonly diagnosed cancers.

Alhough the current study found no difference for mortality due to COPD between genders (males: n = 345 ± 4.01; females: n = 387 ± 3.87; P = .62), the researchers were able to collect data on the incidence of COPD, prevalence of comorbidities, risks of exacerbations, COPD drug prescriptions, and healthcare resource utilization.

Specifically, they found:

• Of the 17,479 patients with COPD, 34.5% had a diagnosis code for asthma at any time during the study.
• The comorbidities more frequently exhibited by females were asthma, fractures, osteoporosis, rheumatoid arthritis, rhinitis, depression, and anxiety.
• The comorbidities that were more frequent in males were type 1 and 2 diabetes, kidney diseases, and cardiovascular diseases.
• Time-to-first-exacerbation analysis showed women have a 12% higher risk of an earlier exacerbation than men (HR, 1.12; 95% CI, 1.09-1.16; P <.0001)
• Women had more moderate exacerbations overall (P <.0001).
• No difference in severe exacerbations (P = .6) was observed compared with men.
• Median survival time from COPD diagnosis to death in men (9.0 years; 95% CI, 8.75-9.30) was shorter than that in women (11.1 years; 95% CI, 10.8-11.5)
• When only COPD-related incidents were analyzed, females had a higher number of hospitalizations, more nights spent at the hospital, and more outpatient visits to hospitals.
• Females receive significantly higher numbers of COPD drug prescriptions than males (except long-acting β₂-agonist/long-acting muscarinic antagonist fixed combinations)

The researchers note that during the later years of the study, they saw a significant decrease in the proportion of incident patients with asthma in both genders. This may be attributed to improved precision in diagnosis over time.

The purpose of the study was “to identify areas for improvement and management and optimize the associated healthcare resource allocations,” for all patients with COPD.

The authors suggest future research should be conducted into gender-specific differences in patients with COPD, along with gender-targeted strategies for treatment and prevention of the disease.

Reference:

Lisspers K, Larsson K, Janson C, et al; Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study [published online December 10, 2019]. NPJ Prim Care Respir Med. doi: 10.1038/s41533-019-0157-3.