Guidelines Recommend Screening All COPD or Treatment-Resistant Asthma Patients for AAT Deficiency

Early Detection Is Critical

Several organizations, including the American Thoracic Society (ATS) and the European Respiratory Society (ERS), recommend screening patients with COPD or treatment-resistant asthma for alpha-1.1-5

The ATS and ERS recommend screening¹:

  • All COPD patients, regardless of age, smoking history, ethnicity, or FEV1 status
  • All adults with symptomatic asthma whose airflow obstruction is incompletely reversible after bronchodilator therapy
  • All adults with symptomatic emphysema, regardless of smoking history
  • Asymptomatic patients with persistent obstruction on pulmonary function tests and with identifiable risk factors (eg, smoking, occupational exposure)
  • All immediate family members of individuals with alpha1-antitrypsin (AAT) deficiency
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“Nowadays, with the guidelines that have been out there since 2003, and I think it is very important we remind that it is 20 years, that we have very clear indication to screen, … This should be incorporated in a practice.”

Igor Barjaktarevic, MD, PhD David Geffen School of Medicine, UCLA

Review Additional Respiratory Guidelines

COPD Foundation recommends screening2:

All adults with symptomatic fixed airflow obstruction, whether clinically labeled as COPD or asthma

Parents, siblings, and children, as well as extended family of individuals identified with an abnormal gene for AAT deficiency

American College of Chest Physicians (CHEST) recommends screening3:

All patients with COPD or emphysema

GOLD, Global Initiative for Chronic Obstructive Lung Disease, recommends screening4:

All patients with a diagnosis of COPD, especially in areas with high AAT deficiency prevalence

Family members of patients diagnosed with AAT deficiency

The World Health Organization (WHO) recommends screening5:

All patients with COPD

Adults and adolescents with asthma

Screening for Alpha-1 in Your Practice

"In the end, when you’ve done the test, you’ve done your duty as a physician."
— D. Kyle Hogarth, MD
University of Chicago

Hear more from Dr Hogarth on screening for alpha-1, along with panel experts Dr James Donohue, Dr Monica Goldklang, and Dr Igor Barjaktarevic.

Watch the Full Video

AlphaID makes screening fast, free, and accurate*

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*The receipt of these free testing services does not create any expectation or obligation to purchase or use any product or service offered by any manufacturer.

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FEV1, forced expiratory volume in 1 second.

References:

  1. American Thoracic Society/European Respiratory Society. American Thoracic Society/European Respiratory Society statement: standards for the diagnosis and management of individuals with alpha-1 antitrypsin deficiency. Am J Respir Crit Care Med.  2003;168(7):818-900.
  2. Sandhaus RA, Turino G, Brantly ML, et al. The diagnosis and management of alpha-1 antitrypsin deficiency in the adult. Chronic Obstr Pulm Dis. 2016;3(3):668-682.
  3. Campos MA, Wanner A, Zhang G, Sandhaus RA. Trends in the diagnosis of symptomatic patients with α1-antitrypsin deficiency between 1968 and 2003. Chest. 2005;128(3):1179-1186. doi:10.1378/chest.128.3.1179
  4. 2024 Gold Report - Global Initiative for Chronic Obstructive Lung Disease. GOLD. November 12, 2023. Accessed May 2, 2024. https://goldcopd.org/2024-gold-report/.
  5. Alpha 1-antitrypsin deficiency: memorandum from a WHO meeting. Bull World Health Org. 1997;75(5):397-415.