ArticleBMC pulmonary medicine2025
Clinical characteristics of AATD-related COPD patients vary with age at diagnosis: data from the EARCO international registry.
Article in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Relationship Between Gas Transfer Measurements, Lung Volumes, and Spirometric Indices in Alpha-1 Antitrypsin Deficiency and Non-AATD COPD: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2026Pooled it
- Alpha-1 Antitrypsin Deficiency-Associated Chronic Obstructive Pulmonary Disease.Medicina (Kaunas, Lithuania) · 2026Review
- Circulating C-terminal peptides and polymers of alpha-1 antitrypsin as putative markers of pediatric Pi*ZZ liver disease.Frontiers in pediatrics · 2025Article
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21 authors.
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Abstract
backgroundThis study aims to evaluate the clinical characteristics of COPD patients with AATD according to their age at diagnosis.
methodsData was obtained from the European Alpha-1 Research Collaboration (EARCO) registry, an international prospective cohort study. AATD patients with COPD registered between February 2020 and October 2024 were analysed. Clinical charateristics were compared between groups, stratified by age of AATD diagnosis as follows; <45, 45-65 and ≥65 years. A multivariable logistic regression model explored factors associated with age at diagnosis.
resultsA total of 1,565 AATD-COPD patients were included, with 18.2% receiving an AATD diagnosis at age ≥ 65. In univariate comparisons according to diagnosis age revealed that the prevalence of patients with Pi*ZZ mutation was lower in the ≥ 65 age group (47.1%) compared to the 45-65 (65.5%) and < 45 (78.5%) age groups. In contrast, the prevalence of Pi*SZ and Pi*SS were higher in the ≥ 65 group compared to the younger age groups. The proportion of never-smokers was highest in the ≥ 65 group (39.5%), whereas only 15.3% of patients under 45 were never-smokers. Multivariate analysis showed that; compared to never-smokers, former smoking (OR: 0.08; 95% CI: 0.03-0.23) and current smoking (OR: 0.43; 95% CI: 0.27-0.70) were negatively associated with a diagnosis at age ≥ 65 in all sample. Compared to the Pi*ZZ genotype, among all sample, Pi*SS was associated with more than a 3-fold increased likelihood of diagnosis at age ≥ 65 and when considering only index cases Pi*SZ was associated with diagnosis age of ≥ 65 (OR: 2.01, 95%CI: 1.01-4.04). Among patients with the Pi*ZZ, current smoking was negatively associated (OR:0.24,95%CI: 0.13-0.47) with a diagnosis at age ≥ 65, whereas higher FEV
conclusionPatients diagnosed at an older age had lower tobacco exposure and less severe disease. This suggests that subclinical symptoms may contribute to delays in diagnosis, as COPD features can be subtle or under-recognised until later in life. Our findings highlight the importance of considering AATD in all COPD patients, regardless of age, to avoid missed or delayed diagnoses.
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