PMID- 38398268
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240227
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 13
IP  - 4
DP  - 2024 Feb 7
TI  - Detection of Alpha-1 Antitrypsin Levels in Chronic Obstructive Pulmonary Disease 
      in Respiratory Clinics in Spain: Results of the EPOCONSUL 2021 Audit.
LID - 10.3390/jcm13040955 [doi]
LID - 955
AB  - BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed condition 
      despite being one of the most common inherited disorders in adults that is 
      associated with an increased risk of developing chronic obstructive pulmonary 
      disease (COPD). The aim was to evaluate the frequency of performing AAT levels 
      and associated factors in COPD patients in an audit conducted in 2021-2022, as 
      well as to compare with a previous audit conducted in 2014-2015. METHODS: 
      EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care 
      provided to COPD patients in respiratory clinics in Spain based on available data 
      from medical registries. RESULTS: 4225 patients with a diagnosis of COPD from 45 
      centers were audited in 2021. A total of 1670 (39.5%) patients underwent AAT 
      determination. Being treated at a specialized COPD outpatient clinic (OR 1.88, p 
      = 0.007), age </= 55 years old (OR 1.84, p = 0.007) and a FEV1 < 50% (OR 1.86, p < 
      0.001) were associated with a higher likelihood of being tested for AAT, while 
      Charlson index >/= 3 (OR 0.63, p < 0.001) and genotyping of AATD availability (OR 
      0.42, p < 0.001) showed a statistically significant negative association. The 
      analysis of cases included in respiratory units that participated in both audits 
      showed an increase in the proportion of cases with AAT serum level testing 
      available (adjusted OR 2.81, p < 0.001). The percentage of individuals with serum 
      AAT levels < 60 mg/dL (a severe AATD) was 4%. CONCLUSIONS: Our analysis 
      identifies significant improvements in adherence to the recommendation to test 
      AAT levels in COPD patients, performed in 4 out of 10 patients, being more likely 
      at younger ages and with higher COPD severity, and with a detection of severe 
      AATD of 4% among those tested, suggesting that clinicians still perform AAT 
      testing in COPD patients selectively. Therefore, efforts are still needed to 
      optimize AATD screening and establish new early detection strategies to reduce 
      morbidity and mortality in these patients.
FAU - Calle Rubio, Myriam
AU  - Calle Rubio M
AUID- ORCID: 0000-0002-3890-2742
AD  - Pulmonology Department, Hospital Clinico San Carlos, Instituto de Investigacion 
      Sanitaria del Hospital Clinico San Carlos (IdISSC), 28040 Madrid, Spain.
AD  - Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 
      28040 Madrid, Spain.
FAU - Miravitlles, Marc
AU  - Miravitlles M
AUID- ORCID: 0000-0002-9850-9520
AD  - Pulmonary Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut 
      de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, 08035 Barcelona, 
      Spain.
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), 
      Instituto de Salud Carlos III, 28029 Madrid, Spain.
FAU - Lopez-Campos, Jose Luis
AU  - Lopez-Campos JL
AUID- ORCID: 0000-0003-1703-1367
AD  - Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), 
      Instituto de Salud Carlos III, 28029 Madrid, Spain.
AD  - Respiratory Disease Medical-Surgical Unit, Instituto de Biomedicina de Sevilla 
      (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, 41009 
      Sevilla, Spain.
FAU - Soler-Cataluna, Juan J
AU  - Soler-Cataluna JJ
AUID- ORCID: 0000-0003-1134-0783
AD  - Pulmonology Department, Hospital Arnau de Vilanova-Lliria, 46015 Valencia, Spain.
AD  - Medicine Department, Valencia University, 46010 Valencia, Spain.
FAU - Alcazar Navarrete, Bernardino
AU  - Alcazar Navarrete B
AUID- ORCID: 0000-0003-2356-9366
AD  - Pulmonary Department, Hospital Universitario Virgen de las Nieves, Instituto 
      Biosanitario de Granada, 18014 Granada, Spain.
FAU - Fuentes-Ferrer, Manuel E
AU  - Fuentes-Ferrer ME
AUID- ORCID: 0000-0002-5177-1441
AD  - Unidad de Investigacion, Hospital Universitario Nuestra Senora de Candelaria, 
      38010 Santa Cruz de Tenerife, Spain.
FAU - Rodriguez Hermosa, Juan Luis
AU  - Rodriguez Hermosa JL
AUID- ORCID: 0000-0003-0552-2484
AD  - Pulmonology Department, Hospital Clinico San Carlos, Instituto de Investigacion 
      Sanitaria del Hospital Clinico San Carlos (IdISSC), 28040 Madrid, Spain.
AD  - Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 
      28040 Madrid, Spain.
LA  - eng
GR  - NA/Sociedad Espanola de Neumologia y Cirugia Toracica/
PT  - Journal Article
DEP - 20240207
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC10889736
OTO - NOTNLM
OT  - chronic obstructive pulmonary disease
OT  - clinical audit
OT  - diagnosis
OT  - outpatient respiratory clinics
OT  - alpha1-antitrypsin deficiency
COIS- J.L.R.H. has received speaker fees from Bial, Boehringer Ingelheim, CSL Behring, 
      GlaxoSmithKline, Zambon and Grifols, and consulting fees from Bial. MM has 
      received speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, 
      GlaxoSmithKline, Menarini, Kamada, Takeda, Zambon, CSL Behring, Specialty 
      Therapeutics, Janssen, Grifols and Novartis; consulting fees from AstraZeneca, 
      Atriva Therapeutics, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, CSL Behring, 
      Inhibrx, Ferrer, Menarini, Mereo Biopharma, Spin Therapeutics, Specialty 
      Therapeutics, ONO Pharma, Palobiofarma SL, Takeda, Novartis, Novo Nordisk, 
      Sanofi, Zambon and Grifols; and research grants from Grifols. J.L.L.C. has 
      received honoraria during the last 3 years for lecturing, scientific advice, 
      participation in clinical studies or writing for publications for (alphabetical 
      order): AstraZeneca, Bial, Boehringer, Chiesi, CSL Behring, Faes, Gebro, Grifols, 
      GSK, Menarini, Zambon. J.J.S.-C. has received speaker fees from AstraZeneca, 
      Bial, Boehringer Ingelheim, Chiesi, FAES, GlaxoSmithKline, Menarini and Novartis; 
      consulting fees from Bial, Chiesi and GSK; and grants from GSK. B.A.N. reports 
      grants and personal fees from GSK; personal fees and non-financial support from 
      Boehringer Ingelheim; personal fees and non-financial support from Chiesi; 
      non-financial support from Laboratorios Menarini; grants, personal fees and 
      non-financial support from AstraZeneca; personal fees from Gilead; personal fees 
      and non-financial support from MSD; personal fees from Laboratorios BIAL; and 
      personal fees from Zambon, outside the submitted work; in addition, Dr. 
      Alcazar-Navarrete has a patent P201730724 issued. M.C.R. has received speaker 
      fees from AstraZeneca, Bial, Chiesi, CSL Behring, GlaxoSmithKline, Menarini and 
      Grifols, and consulting fees from GlaxoSmithKline and Bial. The funders had no 
      role in the design of the study; in the collection, analyses or interpretation of 
      data; in the writing of the manuscript; or in the decision to publish the 
      results.
EDAT- 2024/02/24 11:44
MHDA- 2024/02/24 11:45
PMCR- 2024/02/07
CRDT- 2024/02/24 01:12
PHST- 2024/01/11 00:00 [received]
PHST- 2024/01/29 00:00 [revised]
PHST- 2024/02/01 00:00 [accepted]
PHST- 2024/02/24 11:45 [medline]
PHST- 2024/02/24 11:44 [pubmed]
PHST- 2024/02/24 01:12 [entrez]
PHST- 2024/02/07 00:00 [pmc-release]
AID - jcm13040955 [pii]
AID - jcm-13-00955 [pii]
AID - 10.3390/jcm13040955 [doi]
PST - epublish
SO  - J Clin Med. 2024 Feb 7;13(4):955. doi: 10.3390/jcm13040955.