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Respiratory conditions and treatments

Session: Poster Session C

(326) Sex differences in the risk of exacerbations among patients with chronic obstructive pulmonary disease: a population-based cohort study

Wednesday, August 28, 2024
8:00 AM – 1:30 PM CEST
Location: Convention Hall II

    Presenting Author(s)

  • Marie J. Lu, MS

    Student
    Department of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taiwan (Republic of China)

    • Co-Author(s)

  • SP

    Sheng-Wei Pan, MD

    Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Taiwan (Republic of China)

  • CC

    Chun-Yu Chen, MS

    Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, Taiwan (Republic of China)

  • SS

    Shu-Hui Sun

    Department of Pharmacy, Far Eastern Memorial Hospital, Banciao, New Taipei City, Taiwan, Taiwan (Republic of China)

  • YD

    Yaa-Hui Dong, PhD (she/her/hers)

    Associate Professor
    Department of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
    Taipei, Taiwan (Republic of China)

Background: Physiological differences in the airway and shift in smoking prevalence suggest that, among patients with chronic obstructive pulmonary disease (COPD), women may have a higher risk of exacerbations than men. However, existing evidence on the risk of COPD exacerbations between women and men showed inconsistent findings, possibly due to heterogeneity in study designs. In addition, these studies did not seem to well consider the impact of bronchodilator treatment.

Objectives: Using a population-based cohort study design, we aimed to investigate sex differences in the risk of exacerbations among COPD patients who received the same inhaled bronchodilator treatment.

Methods: We identified COPD patients aged ≥40 years who initiated monotherapy of long-acting bronchodilators from the Taiwan National Health Insurance Research Database between 2017 and 2022. The outcomes of interest were moderate, severe, and moderate or severe COPD exacerbations. We followed patients from cohort entry to outcome occurrence, discontinuation or change of long-acting bronchodilator treatment, death, or end of data (Dec 31, 2022). The Cox proportional regression model was applied to estimate the hazard ratios (HR) and the 95% confidence interval (CI) for each exacerbation outcome, comparing women versus men after 1:10 variable-ratio propensity score (PS) matching.

Results: The study population consisted of 59,461 patients (10,182 women and 49,279 men). The crude incidence rates per 1,000 person-years of moderate, severe, and moderate or severe exacerbations were 179.32, 18.77, and 195.52 for women, respectively; corresponding incidence rates for men were 205.81, 25.69, and 228.59, respectively. In the PS-matched cohort (n=51,945) the HRs of moderate, severe, and moderate or severe exacerbations were 0.86 (95%CI, 0.80-0.93), 0.83 (95%CI, 0.66-1.04) and 0.86 (95%CI, 0.80-0.92) respectively, comparing women to men.

Conclusions: This population-based cohort study observed that women had a lower risk of exacerbations than men among COPD patients initiating monotherapy of long-acting bronchodilators.