A study presented at the American Thoracic Society annual meeting and published in JAMA explored the association between mucus plugs in the airways of patients with chronic obstructive pulmonary disease (COPD) and mortality, revealing concerning findings.
Dr. Alejandro A. Diaz from Harvard Medical School and Brigham and Women’s Hospital in Boston conducted an observational retrospective analysis over a median 9.5-year follow-up period.
The study included 4,363 participants from the Genetic Epidemiology of COPD (COPDGene) cohort across 21 U.S. centers.
The research found that mortality rates increased with the number of lung segments affected by mucus plugs seen on chest CT scans.
Specifically, mortality rates were 34.0%, 46.7%, and 54.1% in patients with mucus plugs in zero, one to two, and three or more lung segments, respectively.
Dr. Diaz noted, “The presence of mucus plugs in one to two versus zero and three or more versus zero lung segments was associated with an adjusted hazard ratio of death of 1.15 (95% CI 1.02-1.29) and 1.24 (95% CI 1.10-1.41), respectively.”
He suggested that airway mucus plugs could potentially be a modifiable target to improve survival in COPD patients, although the observational nature of the study precludes establishing causality.
The study’s findings also highlighted the impact of mucus plugs on airflow obstruction, reduced oxygen saturation, and diminished exercise capacity in COPD patients. Despite these insights, skepticism remains regarding a direct causal link between mucus plugs and mortality.
Dr. George T. O’Connor from Boston Medical Center, who co-chaired the session, emphasized the study’s potential to spur further research into treatments addressing airway obstructions to potentially enhance survival outcomes in COPD.
However, Dr. Donald Mahler from Valley Regional Hospital in New Hampshire, not involved in the study, expressed reservations about the causal association, citing the need for further investigation into the underlying mechanisms.
The study underscored the need for future research to validate these findings and look into therapeutic interventions targeting mucus plugs in COPD patients, aiming to mitigate their impact on mortality.
