Characteristics of patients with physicianassigned COPD without airflow obstruction in NOVELTY

Background: NOVELTY (NCT02760329) is a global, prospective, observational study of patients with a physician diagnosis or suspected diagnosis of asthma and/or COPD. Objective: To describe the characteristics of patients with physician-assigned COPD without airflow obstruction or with Preserved Ratio but Impaired Spirometry (PRISm). Methods: We compared characteristics of patients with COPD (no diagnostic criteria specified) without airflow obstruction, with PRISm or with GOLD 1 airflow limitation (Table). Results: Of 3,198 patients with COPD and available post-bronchodilator spirometry, 424 (13.3%) were without airflow obstruction, 288 (9.0%) had PRISm and 314 (9.8%) had GOLD 1. Patients without airflow obstruction and patients with PRISm were younger, more often female, more obese and had earlier onset of symptoms and less smoking exposure than the GOLD 1 group (Table). Patients without airflow obstruction were more likely to have physician-assigned mild COPD than patients with PRISm. However, comorbidity, cough, breathlessness, exacerbations, patient-reported symptomatic worsening and inhaled corticosteroid prescription were frequent in all groups. Conclusions: Patients were frequently diagnosed with (and treated for) COPD without meeting standard spirometric criteria. These patients had risk factors and symptoms suggestive of airways disease. The prognosis and natural history of such patients are poorly understood.