Abstract
Alpha-1-antitrypsin deficiency (AATD) significantly increases the risk of developing COPD, and testing of all COPD patients for AATD is recommended by the WHO, ERS and GOLD. We aimed to determine trends for testing and diagnosing of AATD from 1990 to 2014.
This study analyzed all patients diagnosed with COPD from about 550 UK OPCRD general practices, including a subgroup of those diagnosed before the age of 60 years.
We identified 107,024 COPD individuals, of whom 29,596 (27.6%) were diagnosed before 60 years of age. Of them, only 2.2% (95% CI 2.09%–2.43%;) had any record of being tested for AATD. Of those tested 23.7% (95% CI 20.5%–27.1%) were diagnosed with AATD. Between 1994 and 2013 the incidence of AATD diagnosis generally increased. A diagnosis of AATD was associated with being male, being an ex-smoker, more severe COPD with a lower %pred FEV1, and higher GOLD 2017 stages (all p<0.05).
Despite an increase in the frequency of AATD testing since 1990, only 2.2% of patients diagnosed with COPD before the age of 60 years were tested. AATD prevalence was 23.7% in those tested. Thus, it appears that AATD remains markedly underdiagnosed in COPD patients.
Abstract
AATD remains markedly underdiagnosed in COPD patients, and case-finding strategies for both conditions should be implemented
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Joan B. Soriano
Conflict of interest: Sarah J. Lucas
Conflict of interest: Rupert Jones
Conflict of interest: Marc Miravitlles
Conflict of interest: Victoria Carter
Conflict of interest: Iain Small
Conflict of interest: David Price
Conflict of interest: Ravi Mahadeva
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