Characteristics of Preserved Ratio Impaired Spirometry (PRISm) patients in Austrian real world COPD studies

<bold>Objective:</bold> PRISm is a lung function definition (FEV1/FVC > 0.7) for patients at risk of developing chronic airflow obstruction and is associated with other cardiorespiratory diseases. Here, we characterize real world PRISm patients of CLARA I&II, 2 Austrian real world studies of stable COPD patients. <bold>Methods:</bold> In 1874 CLARA I&II patients, PRISm (FEV1/FVC > 0.7 but FEV1 < 80% predicted), COPD (FEV1/FVC < 0.7) and non-obstructive patients (FEV1/FVC > 0.7 and FEV1 > 80% predicted) were compared regarding demographics, smoking, symptom control (SGRQ-C), comorbidities and exacerbation history. Current medication, reported pain and mental health status (PHQ-9) for all 3 groups were assessed in CLARA II only (n= 796). A logistic regression model compared PRISm with COPD patients. <bold>Results:</bold> PRISm (n= 336 (17.9%)) and COPD (n= 1480 (79%)) patients showed a similar age and gender distribution. In the logistic regression model, PRISm (n= 137) patients had higher BMI (OR: 1.07 (1.04–1.10), p <0.001), were more likely to report current smoking (OR: 1.52 (1.14–2.04), p = 0.005) and less likely to report hypertension (OR: 0.98 (0.977–0.98), p = 0.031) compared to COPD patients (n=630). Non-obstructive (n= 58 (3.1%)) patients were younger, more often current smokers, had lower SGRQ-C scores, less dyspnea and exacerbations, were less frequent on Triple- but more often on LAMA/LABA therapy but with comparable PHQ-9 and pain scores. <bold>Conclusion:</bold> PRISm patients defined in two real world studies are a relevant subgroup of patients with impaired spirometry. PRISm patients present with a distinct clinical profile, higher BMI and are more likely current smokers but are otherwise comparable to COPD patients.