Persistent, New Mucus Plugs Associated With Faster Decline in FEV1 in COPD

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Medically reviewed by Carmen Pope, BPharm. Last updated on May 21, 2025.

By Elana Gotkine HealthDay Reporter

WEDNESDAY, May 21, 2025 -- For patients with chronic obstructive pulmonary disease (COPD), persistent and newly formed mucus plugs are associated with a faster decrease in forced expiratory volume in one second (FEV1), especially in those who continue or resume smoking, according to a research letter published online in the May 15/22 issue of the New England Journal of Medicine.

Sofia K. Mettler, M.D., M.P.H., from Brigham and Women's Hospital in Boston, and colleagues assessed participants in the Genetic Epidemiology of COPD study who had at least 10 pack-years of smoking history to examine the association between change in mucus plugs and decrease in FEV1. Mucus plugs were surveyed with computed tomography at baseline and five-year follow-up. Participants were classified according to change in mucus plugs: persistently negative, resolved, newly formed, and persistently positive.

Five-year follow-up data were available for 2,118 participants. At follow-up, the status changes in mucus plugs were persistently negative, resolved, newly formed, and persistently positive in 44.1, 16.1, 19.7, and 20.1 percent, respectively. The mean decrease in FEV1 was 37.2 mL per year in the persistently negative group compared with 39.3, 54.9, and 60.4 mL per year for the resolved, newly formed, and persistently positive groups, respectively. Compared with the persistently negative group, the difference in FEV1 decrease was meaningful in the persistently positive and newly formed groups and not substantial in the resolved group. The steepest decrease in FEV1 was seen among participants in the persistently positive group who resumed smoking, while the least decrease was seen in the resolved group who quit smoking.

"Persistent and newly formed mucus plugs were associated with a faster decrease in FEV1, a change that was more pronounced in participants who resumed or continued smoking," the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

Source: HealthDay

Posted : 2025-05-22 06:00

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