COPD plus GERD, diabetes or osteoporosis raises odds for exacerbations, health care use

Key takeaways:

• Health care resource utilization captured ED and hospital visits related to COPD.
• Among adults with COPD, GERD was the most frequent comorbidity of the three.

Having GERD, diabetes or osteoporosis in addition to COPD heightened the likelihood for exacerbations, ED visits and hospitalizations, according to results published in Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation.

“These findings from real-world data support the results of previous studies showing that diabetes, GERD and osteoporosis are comorbidities frequently observed in patients with COPD and that they impact the risk of exacerbation,” Jamuna K. Krishnan, MD, MBA, MSc, assistant professor of medicine at Weill Cornell Medical College, and colleagues wrote.

Using Optum’s Clinformatics Data Mart Database, Krishnan and colleagues conducted a retrospective noninterventional cohort study of 158,106 adults with COPD (mean age, 71.09 years; 55.7% women; 17.2% with underweight status; 19.2% with severely obese weight status) vs. 158,106 adults without COPD (mean age, 70.88 years; 58.5% women; 8.2% with underweight status; 10% with severely obese weight status) — both matched according to age — to establish how the prevalence of GERD, diabetes and osteoporosis/osteopenia differs between the two groups.

Researchers also evaluated how the odds for COPD exacerbations and COPD-related health care resource utilization change based on the presence of each of the comorbidities.

GERD was reported in 44.9% of patients with COPD, whereas only 27.8% of adults without COPD had this morbidity. Similarly, diabetes impacted 40.8% of the group with COPD vs. 31.1% of the group without COPD. Osteoporosis/osteopenia was less frequent than GERD and diabetes but still appeared in more adults with vs. without COPD (18.8% vs. 14.1%), according to the study.

Within the group of age-matched patients with COPD, the odds for exacerbations and COPD-related health care resource utilization significantly went up among those with vs. without GERD (n = 71,150 each): severe exacerbations (OR = 1.819), moderate exacerbations (OR = 1.699), any exacerbations (OR = 1.848), ED visits (OR = 1.983) and hospitalization visits (OR = 2.222).

Researchers further observed significant elevated odds for each of the above outcomes when comparing age- and weight-matched patients with COPD with vs. without osteoporosis/osteopenia (n = 32,895 each): severe exacerbations (OR = 1.373), moderate exacerbations (OR = 1.322), any exacerbations (OR = 1.384), ED visits (OR = 1.343) and hospitalization visits (OR = 1.368).

Lastly, age- and weight-matched patients with COPD and diabetes (n = 55,182) had significantly greater odds for all the assessed outcomes — severe exacerbations (OR = 1.119), moderate exacerbations (OR = 1.102), any exacerbations (OR = 1.099), ED visits (OR = 1.098) and hospitalization visits (OR = 1.26) — vs. patients with COPD without diabetes (n = 55,182), according to the study.

“There are no current COPD treatments which address extrapulmonary morbidities and, therefore, there is an urgent unmet need for novel therapies that address key underlying pathologies and reduce the disease burden for patients with COPD,” Krishnan and colleagues wrote.