Clinical Differences Between Patients With COPD Due to Biomass Smoke or Tobacco

Abstract

SESSION TITLE COPD IISESSION TYPE: Slide PresentationsPRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:00 AMPURPOSE: Biomass smoke exposure is a risk factor for developing chronic obstructive pulmonary disease (COPD). Little is currently known concerning clinical differences between COPD due to tobacco and to biomass smoke. The purpose of this study was to search for clinical differences between both types of diseaseMETHODS: Retrospective observational study of 499 patients diagnosed of COPD due to tobacco or to biomass smoke exposure. Both groups were compared regarding the prevalence of several predefined clinical phenotypes, severity of the disease measured using several markers, and weight of comorbidities assessed using the Charlson and the COTE indicesRESULTS: Three hundred and seventy seven patients (75.5%) were included in the tobacco group and 122 (24.4%) in the biomass group. There were more males in the tobacco 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 biomass group (21.3% vs 5%, p < 0.0001), although this difference disappeared on adjustment for sex. The emphysema phenotype was more frequent in the tobacco group (45.9% vs 31.9%, p = 0.009). The chronic bronchitis and frequent exacerbator phenotypes were similarly distributed between both groups. The weight of comorbidities and the rate of hospital admissions were also similar between the biomass and tobacco groupsCONCLUSIONS: There are several clinical differences between patients with COPD due to tobacco and to biomass smoke exposure, although some of them might be partially attributable to sex differences between both groupsCLINICAL IMPLICATIONS: The fact that COPD due to biomass smoke has a different clinical presentation suggests that the natural history, the rate of progression and the inflammatory pattern might be different to COPD due to tobacco. This fact might have therapeutic implications. Further studies should be carried out to clarify this pointDISCLOSURE: Pilar Sanjuán: 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 Pérez-de-LLano: Grant monies (from industry related sources): Almirall, Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Novertis, Astra-Zeneca, Boehringer-Ingelheim, GSK, Menarini Esteban Cano: Consultant fee, speaker bureau, advisory committee, etc.: GSK Olalla Castro-Añon: Consultant fee, speaker bureau, advisory committee, etc.: NovartisNo Product/Research Disclosure Information.