COPD: sex differences in comorbidities and outcomes

Takeaway

• ARCTIC, a real-world cohort study of almost 17,500 patients with COPD in 52 primary care practices, showed sex differences in outcomes, with higher rates of exacerbations and hospitalisations among women and greater overall mortality in men.

Why this matters

• Findings suggest the need to reduce sex differences through better diagnosis and treatment.

Study design

• A retrospective cohort study of patients with COPD (N=17,479) in 52 primary care practices in Sweden.
• Funding: Novartis Pharma AG.

Key results

• Mean follow-up, 12.4 years.
• Women at a disadvantage:
  • Greater comorbid asthma, fractures, rheumatoid arthritis, depression, anxiety (all P<.0001).
  • Greater comorbid osteoporosis and rhinitis (no P value given).
  • Greater number of moderate exacerbations (6.66 vs 4.66; P<.0001) and exacerbations of any severity (88% vs 84%; P<.0001).
  • Higher rate of earlier exacerbation (HR, 1.12; P<.0001).
  • Greater number of COPD-related hospitalisations per year (P=.007).
  • Greater number of COPD drug prescriptions (no overall P given).
• Men at a disadvantage:
  • Greater comorbidity with type 1 and 2 diabetes, kidney disease, and cardiovascular disease (all P<.0001).
  • Greater overall mortality (45% vs 38% in women; P<.0001).
  • Smaller median survival time from COPD diagnosis to death (9.0 vs 11.1 years; no P value given).
• No sex differences in severe exacerbations (P=.60).

Limitations

• No P values are given for some comorbidities and outcomes.
• Retrospective, observational design.