Chest
Original ResearchCOPDClinical Characteristics of Subjects With Symptoms of α1-Antitrypsin Deficiency Older Than 60 Years
Section snippets
Materials and Methods
The study comprised 1,062 members of AlphaNet, a not-for-profit health management company that coordinates services for patients with AATD in the United States (including the organization and distribution of augmentation therapy) who consent to participate in a disease management program. The data analyzed here correspond to the clinical outcomes recorded during a pre-intervention 12-month control period. For the study, coordinators (all subjects with AATD employed by AlphaNet) were trained by
Results
Of the 1,062 participants who were enrolled in the study, 34 patients were excluded because of lung transplantation at study entry. During follow-up, 15 patients were excluded because of new lung transplant during the study period, 10 patients withdrew from the study, 6 patients were unavailable for follow-up, and 19 patients died. Subjects not receiving augmentation therapy (n = 42) and with incomplete monthly data collection (n = 14) were excluded from the analysis. Thus, the current analysis
Discussion
Our study shows that individuals with symptomatic AATD-associated COPD who reach the age of 60 years or more, represent a group with particular clinical characteristics. These older individuals have less symptomatic AATD, experience fewer acute disease exacerbations and have better HRQoL scores than younger individuals affected with AATD. Due to an apparent slower decline in lung function, the older individuals experience a longer diagnostic delay and receive a diagnosis later in life. These
Acknowledgment
We thank John Walsh from the Alpha One Foundation, all AlphaNet personnel, particularly Robert Barrett, Bonnie Boyd, and Rosemarie Carillo, and all of the AlphaNet coordinators (Terry Young, Gayle Allison, Roger Bray, Patti Brown, Victoria Cameron, Robert Campbell, Shirley Dennis, Joyce Finch, Phil Freeman, Kathy Haduck, Randy Harwell, Pat MacInness, Darrel Nall, Diana Patterson, Mary Pierce, Judy Rose, Sandy Singleton, Kathleen Sivesind, Marta Strock, Kay Kinsel Swift, Doug Turley, Liz
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2014, Clinics in Chest MedicineCitation Excerpt :Once these index individuals had been identified, family screening identified further deficient subjects as nonindex patients and, in general, these individuals have much less severe disease.7 Subsequent testing also confirmed that never smokers also had less clinical evidence of lung disease8 and more often presented later in life.9 However, in recent years testing has become more widespread and the variability of the age of presentation has become more apparent as well as variations in the clinical phenotype.
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Funding for this study was provided by AlphaNet, Inc., Miami, FL.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).