Impact of chronic bronchitis in moderate COPD

<bold>Objectives:</bold> The presence of chronic bronchitis (CB) in COPD is known to be associated with worse clinical outcomes. Such studies were performed in patients already identified at being at risk of severe outcomes, because mean forced expiratory volume in one second (FEV₁) was ≤50% predicted. Less is known about its impact in milder COPD. <bold>Methods:</bold> Data are from the baseline of COMPASS (Liang, et al. <italic>ERJ Open Res</italic> 2021;7:00201). Patients were categorised into presence of CB (CB+) and absence (CB-) using the Medical Research Council definition. <bold>Results:</bold> 1696 patients with COPD were included, of whom 89.6% were male, mean age was 65.4 years, mean post-bronchodilator FEV₁ was 66.6% predicted; and 66.1% were CB+. There was no difference in age, gender, or body mass index, but CB patients had greater pack years (49.9 vs 44.4, p<0.0001). Post-bronchodilator FEV₁, forced vital capacity (FVC) and FEV₁/FVC were significantly lower in CB+ and all other outcomes were significantly worse in CB+ (<bold>Table</bold>). Differences in CAT and SGRQ scores exceeded their minimum clinically important differences, and the rate ratio for moderate/severe exacerbations was 2.6. <bold>Conclusion:</bold> The presence of CB in moderate airflow limitation was associated with significantly worse COPD outcomes on every measure. This suggests that CB status should be assessed in all patients with COPD, even in those with mild or moderate airflow limitation. <bold>Funding:</bold> GSK (208630). <fig><object-id>erj;64/suppl_68/PA3041/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>