Gender determinants of exacerbations in COPD patients: the French Palomb Cohort.

<bold>Introduction:</bold> Chronic obstructive pulmonary disease (COPD) is no longer a disease affecting exclusively men. Women with COPD have different symptoms and a more severe form of disease, in specific contexts. The aim of this work was to investigate differences regarding the frequency of exacerbations in men and women in France. <bold>Methods:</bold> Patients at any disease severity stage recruited and followed-up since 2013 by almost 50 pulmonologists located in 2 French regions. Data collected: FEV1, exacerbations, cough, expectoration, smoking status, comorbidities (n=25), treatments. Multivariable logistic regression models were used to identify the determinants of frequent exacerbations (≥2) using Bonferroni correction. <bold>Results:</bold> In February 2024, a total 3,265 patients were included and 36.7% were women. Women had more exacerbations (≥2) compared to men (31.3% vs. 22.9%). Among patients with ≥2 exacerbations (n= 849) men had significantly more cough (77.8% vs. 69.1%) and expectoration (63.3% vs. 51.2%). In multivariable analyses, female sex was associated to a higher risk of having frequent exacerbations (aOR=1.52; CI95%[1.28 – 1.81]). In 2 separate models, GOLD stage III-IV, anxiety and expectoration were common factors related to have frequent exacerbations in both sex, while younger age, dyspnea, pneumococcal vaccination were found in women and cough, occupation at risk of COPD, influenza vaccination, having a COPD treatment, pulmonary rehabilitation were found among men. <bold>Conclusion:</bold> In a large real-life cohort of COPD patients, our results suggest that factors related to frequent exacerbations profile are different in men and women. <bold>Sponsors:</bold> Boehringer Ingelheim, Chiesi, Gsk, Isis Medical, Novartis