Abstract
The percentage of α1-antitrypsin protease inhibitor ZZ (PiZZ) genotypes in patients with COPD is controversial, with large differences among various studies. We aimed to estimate the prevalence of PiZZ in COPD patients from 20 European countries with available data, according to the number of PiZZ and COPD individuals in each country.
A systematic review was conducted to select European countries with reliable data on the prevalence of PiZZ and COPD. We created a database with the following data: 1) total population and population aged ≥40 years according to the Eurostat database; 2) number and 95% CI of PiZZ patients aged ≥40 years; 3) application of a conversion factor of genetic penetrance of 60%; 4) number of COPD individuals, with 95% CI, aged ≥40 years; and 5) calculation of the PiZZ/COPD ratio. Finally, results were presented using an Inverse Distance Weighted Interpolation map.
We found 36 298 (95% CI 23 643–56 594) PiZZ individuals at high risk and 30 849 709 (95% CI 21 411 293–40 344 496) COPD patients, with a PiZZ/COPD ratio of 0.12% (range 0.08–0.24%), and a prevalence of 1 out of 408 in Northern, 1 out of 944 in Western, 1 out of 1051 in Central, 1 out of 711 in Southern, and 1 out of 1274 in Eastern Europe.
These data may be useful to plan strategies for future research and diagnosis, and to rationalise the available therapeutic resources.
Abstract
There is a significant number of PiZZ individuals at high risk of COPD, as well as an impressive number of patients with COPD in Europe. The ratio between PiZZ and COPD ranges between 0.08% and 0.24%, with wide differences among countries. https://bit.ly/2VrOzUv
Footnotes
Author contributions: All the authors have contributed to the elaboration of the manuscript and have approved its final version. I. Blanco, I. Diego and M. Miravitlles are the guarantors of the paper.
Provenance: Submitted article, peer reviewed
Conflict of interest: I. Blanco has nothing to disclose.
Conflict of interest: I. Diego has nothing to disclose.
Conflict of interest: P. Bueno has nothing to disclose.
Conflict of interest: S. Pérez-Holanda has nothing to disclose.
Conflict of interest: F. Casas-Maldonado has nothing to disclose.
Conflict of interest: M. Miravitlles reports speakers fees from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Menarini, Rovi, Bial, Zambon, Sandoz, CSL Behring, Grifols and Novartis; consultancy fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Bial, Gebro Pharma, CSL Behring, Laboratorios Esteve, Ferrer, Mereo Biopharma, Verona Pharma, Kamada, TEVA, Sanofi, pH Pharma, Novartis and Grifols; grants from GlaxoSmithKline and Grifols, outside the submitted work.
- Received January 18, 2020.
- Accepted April 5, 2020.
- Copyright ©ERS 2020.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.