COPD in special populations- focus on younger and never-smoking patients from two Austrian real world studies

<bold>Objective:</bold> Most COPD patients (pts) are > 60 yrs and have a smoking history. In this analysis of 2 Austrian real world studies of pts on COPD medication, CLARA I & II, we characterized 2 subgroups, the never smokers and the younger COPD pts. <bold>Methods:</bold> CLARA I & II were Austrian cross-sectional studies, analysing pts with stable COPD between 09 -12/2018 and 09/21 - 01/22, respectively. Data were pooled and clustered by age and smoking status in 4 groups (≤ 60 vs > 60 yrs; never smoker (NS) vs. Current/Former smokers (Cur/For). Pts were characterized according to St. George Respiratory Questionnaire for COPD pts (SGRQ-C), Patient Health Questionnaire 9 (PHQ-9) – a screening tool for mental health -, therapy classes, pain and physical activity. <bold>Results:</bold> <table-wrap><object-id>erj;64/suppl_68/PA1234/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col><col></col></colgroup><tbody><tr><td>1480 COPD</td><td> ≤ 60 years</td><td>> 60 years</td></tr><tr><td>NS</td><td>23 (group 1)</td><td>142 (group 3)</td></tr><tr><td>Cur/For</td><td>362 (group 2)</td><td>953 (group 4)</td></tr></tbody></table></table-wrap> NS was significantly more frequent in the agegroup > 60 yrs (Chi2 p<0.001). Compared to group 4, group 1 suffered less from dyspnea (56.5% vs. 79.1%, p=0.009), hypertension (26.1% vs. 49.0%, p=0.030) and there was a trend to less frequent exacerbations (13.0% vs. 22.2%; p=0.293). The disease burden (SGRQ-C mean score: 37 vs. 41.6, p=0.456) and the use of triple therapy was comparable (45.5% vs. 48.9%). In pts >60 yrs, NS had significantly less cough vs. Cur/For (32.9% vs. 52.6%; p<0.001). Also phlegm was associated with smoking. Average pain and mental health (PHQ-9) were comparable. <bold>Conclusion:</bold> In a real world setting in Austria, younger and NS pts on COPD therapy represent a minority. They are characterized by less COPD symptoms and less hypertension. NS COPD is significantly associated with older age, but less cough, phlegm, and dyspnea.