Analysis and characteristics of COPD patients with and without alpha-1 antitrypsin deficiency

Introduction: The objective of this study is to understand the functional characteristics of our patients with AATD and compare them with COPD patients without this disorder. Materials and Methods: This was a one-year, prospective, observational study of 23 patients, 11 of whom had AATD and 12 without. Various variables were collected, including demographics, mutation type, and respiratory function tests. These patients were subsequently followed up, and all functional tests were repeated one year later to assess respiratory outcomes with the prescribed treatments. Results: Of the study group (COPD and AATD), 45.4% were women. Mean age of 63.6±9.3. 90% were smokers, with a cumulative index of 46.5±24.9 pack-years. Functional tests and 6MWT were performed at the first consulting. At one year, PFR and 6MWT were performed again. During that period, various treatments were administered, including: 3 patients began treatment with AAT supplements, 1 patient was referred for transplant, and the rest received inhalation therapy according to clinical practice guidelines. However, 4 patients experienced exacerbations, 3 of whom had chronic bronchial infection (2 with Pseudomonas and 1 with Klebsiella). One patient died. In contrast, the control group, consisting of COPD patients without AATD, had a mean age of 70.5±10.2, 91.6% were men, and 100% were current smokers with a cumulative index of 55±28 pack-years. During this period, all patients received inhalation therapy according to clinical practice guidelines. Seven of them also experienced respiratory exacerbations, but none of them had chronic bronchial infections. Baseline and one-year data of two groups are shown in [ Fig. 1 ]. No statistically significant differences were found between the two groups in terms of meters walked, lung function, exacerbations, or chronic bronchial infections. Conclusions: Patients with AATD have a worse functional outcome after exacerbations and a higher rate of chronic bronchial infections. However, the study cohort is too small to obtain robust conclusions; more patients would be needed to expand this study. Fig. 1 Publication History Article published online: 04 March 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany