Franziska Trudzinski, MD: Identifying Gender-Specific Pulmonary Disorders in COPD

A new sex-based cohort study identified several pulmonary and extra-pulmonary disorders in patients with chronic obstructive pulmonary disease (COPD) that showed marked differences between men and women regarding their association with mortality.

The data were presented at the American Thoracic Society 2020 International Conference in San Francisco.

In an interview with HCPLive, study author Franziska Trudzinski, MD, of the University of Heidelberg in Germany, spoke of limited data regarding COPD prevalence in female patients.

Recent research has suggested that COPD prevalence is underreported in female patients, with some literature even suggesting higher prevalence in females compared to male patients.

“In most studies, females report more exacerbations than males, and we know also that females have a higher symptom burden,” Trudzinski said. “Also, with regard to comorbidities- and this was actually what inspired us to do this study now- we saw that (females) present with different symptoms. According to the same comorbidity, females with cardiac disease presented with a chest tightness and males with cardiac comorbidities reported a loss in energy. So, I do think that comorbidities have different impact in different genders.”

Trudzinski and colleagues examines sex differences in COPD comorbidities regarding prognosis by classifying comorbidities regarding the disease into a comorbidome related to extrapulmonary disorders and a pulmorbidome.

A total of 1044 women and 1531 men with a diagnosis of COPD were assessed for these comorbidities, with significant differences between gender regarding the association with pulmorbidome and comorbidome being observed.

Comorbidities such as obesity, hypertension, liver cirrhosis, and kidney disease predicted mortality in male patients, while hyperuricemia, mental disorders, kidney disease and increased heart rate predicted mortality in female patients.

Regarding the pulmorbidome, significant predictors in men were impairment in diffusion capacity and hyperinflation, in women asthma and hyperinflation.

Trudzinski suggested that physicians could use these data on different comorbidities to accurately diagnose COPD in both women and men in an unbiased way, stating that “reliable information about comorbidities” for patients was urgently needed.

“We need to question whether it would make sense also to include gender in our risk assessment, because different comorbidities have a different impact on prognosis in in males and females,” she noted. “So maybe we need to judge the impact of comorbidities in a different way.”

To hear more from Dr. Trudzinski, watch the full interview above.