Clinical characteristics differ already a decade prior to observed lung function trajectories in airway obstructive individuals

<bold>Background:</bold> We have previously identified three post-bronchodilatory FEV₁ trajectories with different prognosis among obstructive individuals in the OLIN COPD study; T1 (stable high FEV₁, lowest mortality), T2 (rapid decline, increased mortality compared to T1), and T3 (stable low FEV₁, highest mortality). <bold>Aim:</bold> To investigate clinical characteristics a decade prior to observed trajectory membership in the OLIN COPD study. <bold>Methods:</bold> All obstructive participants in the OLIN COPD study (n = 993, FEV₁/VC<0.7) were recruited after re-examination of adult cohorts in 2002-04. Data on lung function and clinical characteristics were extracted from these cohorts first examinations during the 80s and 90s and, linked to trajectory membership. <bold>Results:</bold> Retrospective data, on average 10 years prior to inclusion in the OLIN COPD study, were available from n=723 (93%), n=109 (86%) and n=70 (90%) in T1, T2 and T3, respectively. The results are displayed by trajectory in the table. <table-wrap><object-id>erj;66/suppl_69/PA1533/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col></colgroup><tbody><tr><td> <bold>Clinical characteristics at first examination</bold> </td></tr><tr><td></td><td><bold>T1</bold></td><td><bold>T2</bold></td><td><bold>T3</bold></td></tr><tr><td>Age yr, mean</td><td>55.6</td><td>47.5</td><td>60.4</td></tr><tr><td>Women,%</td><td>48.1</td><td>18.3</td><td>55.7</td></tr><tr><td>Ever smoker,%</td><td>73.2</td><td>100.0</td><td>80.0</td></tr><tr><td>Respiratory medication, any,%</td><td>24.5</td><td>14.7</td><td>51.4</td></tr><tr><td>ICS,%</td><td>10.5</td><td>2.8</td><td>24.3</td></tr><tr><td>Diagnosed chronic bronchitis/emphysema,%</td><td>15.5</td><td>11.9</td><td>40.0</td></tr><tr><td>Diagnosed asthma ever,%</td><td>22.1</td><td>11.9</td><td>41.4</td></tr><tr><td>Obstructive,%</td><td>42.5</td><td>42.2</td><td>81.4</td></tr><tr><td>PRISm,%</td><td>19.2</td><td>16.5</td><td>15.7</td></tr><tr><td>FEV₁%pred, mean</td><td>80.5</td><td>79.3</td><td>49.7</td></tr><tr><td>FEV₁decline ml/yr, mean</td><td>39.7</td><td>56.4</td><td>45.2</td></tr></tbody></table></table-wrap> <bold>Conclusion:</bold> Individuals with airway obstruction in T1, T2 and T3 had different clinical profiles already a decade before the observed trajectory belonging, emphasizing the importance of early identification of at-risk phenotypes to tailor preventive and therapeutic strategies.