Top-10 comorbidities of symptomatic patients with moderate COPD in the clinical setting of the CRYSTAL study

Background: In most COPD trials a selected patient population is evaluated. The CRYSTAL study collects information on patients managed in a clinical setting. As COPD patient outcomes are partly driven by comorbidities there is a need to understand their pattern in clinical practice. Methods: CRYSTAL evaluates efficacy and safety of switch from previous therapy directly to glycopyrronium or indacaterol/glycopyrronium fixed dose combination over 12 weeks in non-exacerbating symptomatic patients (mMRC≥1) with moderate airflow limitation (FEV 1 50-80% pred.). We evaluated the Top-10 comorbidities in patients included in CRYSTAL after 1 year of recruitment. Results: 3183 patients (mean FEV 1 64.6% pred.) were recruited, of which 39.3% had mMRC≥2. Most common comorbidities were hypertension, hypercholesterolemia/hyperlipidemia, cardiovascular disease, diabetes, osteoarthritis, benign prostate hyperplasia, depression, gastroesophageal reflux disease, dyslipidemia, and osteoporosis. Cardiometabolic comorbidities were more frequent in patients with a higher mMRC grade (Table). Conclusion: In a clinical practice setting, the majority of patients with moderate airflow limitation had significant comorbidities that were more common in more symptomatic ones. Since comorbidities have impact on patient outcomes, there is a need for careful identification and management of these, especially in the more symptomatic COPD patients.