Characteristics of COPD patients in a community spirometry service and their eligibility for biologic therapy

<bold>Background:</bold> A community airway diagnostic initiative was established in Merseyside (UK) to support primary care access to spirometry and expert review. This study aims to describe the characteristics of those diagnosed with COPD and identify those who may be eligible for future biologic therapies. <bold>Methods:</bold> Data were retrospectively reviewed for patients attending the service between 01/11/23-04/01/24. Patients diagnosed with COPD were identified (105) as those with post-BDR FEV₁/FVC<0.7. Demographic data, eosinophil count (EC) and inhaler prescription data were collected. <bold>Results:</bold> Of 869 patients reviewed, 105 (12.1%) were diagnosed with COPD. Of these, 64 (60%) were initially referred for suspected COPD with a positive referral rate of 16.7%. The COPD cohort was predominantly female (51.4%) and of White British ethnicity (67%) with a median age of 63.5 years (IQR=58-73). 52% were current and 47% ex-smokers with a mean MRC of 2.88 (SD=1.13). 20% were on dual and 9% triple inhaler therapy at time of diagnosis. 54% of the cohort had mild, 33% moderate and 13% severe COPD as per GOLD criteria. Mean EC was 0.31x10⁹/L (SD=0.25) with 60% having an EC≥0.3 x10⁹/L and 87% ≥0.15x10⁹/L. Of those on triple therapy post-diagnosis (n=22), 95% (n=21) had an EC≥0.15x109/L of which 71% (n=15) had one or more exacerbations in the last 12 months. Only 26% of COPD patients underwent FeNO testing with a median of 11ppb (IQR=6-17). <bold>Conclusion</bold> Confirmation of diagnosis is essential for initiating the correct treatment. Understanding the proportion of patients who may be eligible for biologics helps plan future specialist services.