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BD, bronchodilator; CI, confidence interval; COPD, chronic obstructive pulmonary disease; CT, computed tomography; FEV1, forced expiratory volume in one second; GOLD, Global Initiative for Chronic Pulmonary Obstructive Disease; HR, hazard ratio; MUC5AC, mucin-5 AC
*Computed tomographic lung scans from 31 patients with COPD from the SubPopulations and InteRmediate Outcomes In COPD Study (SPIROMICS) cohort.
Annotated computed tomography of mucus plugs in patients with chronic obstructive pulmonary disease, showing the heterogeneity of size and shape.
Coloured arrows point to an elliptical region showing the mucus plugs visible on the lung scans.
Reproduced from Farooqui ON, et al. Mucus plugs in chronic obstructive pulmonary disease are heterogeneous in size and shape and occur in relatively large airways. Am J Respir Crit Care Med. 2026;212(2):268–76. doi: 10.1093/ajrccm/aamaf138. Article distributed under the terms of the CC BY 4.0 license.
Mucus plug scores determined from CT scans from COPDGene study participants3
*Mucus plug score calculated from the number of lung segments with mucus plugs. Mucus plugs were defined as an opacity that completely occluded the lumen of an airway3
Figure developed using Table 1 from: Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease by Diaz AA, et al. JAMA. 2023;329:1832–1839. https://jamanetwork.com/journals/jama/fullarticle/2805343
*Results are from a retrospective observational study evaluating patients in Korea (n=623) who were regularly followed up for COPD management at a teaching hospital between January 2004 and December 20196
Results are from an observational retrospective analysis of prospectively collected data from patients with a diagnosis of COPD, aged 45–80 years, with a smoking history of at least 10 pack-years. Participants were enrolled at 21 centres across the US between November 2007 and April 2011, and were followed up through August 31, 2022. 4363 patients were included in the primary analysis
*Mucus plug score assigned based on the number of lung segments with mucus plugs3
Figure developed using Table 2 from: Airway-Occluding Mucus Plugs and Mortality in Patients With Chronic Obstructive Pulmonary Disease by Diaz AA, et al. JAMA. 2023;329:1832–1839. https://jamanetwork.com/journals/jama/fullarticle/2805343
*Mucus plugs were surveyed with CT at baseline (phase 1) and at a 5-year follow-up visit (phase 2); †No mucus plugs observed at baseline or 5-year follow-up; ‡Mucus plug only present at baseline; §Mucus plug only present at 5-year follow-up; ¶Mucus plug present at baseline and 5-year
follow-up15
Figure developed using Figure 1B from: Longitudinal changes in airway mucus plugs and FEV1 by Mettler SK, et al. N Engl J Med 2025;392:
1973–1975. https://www.nejm.org/doi/full/10.1056/NEJMc2502456
In the COPDGene study,* ~75% of patients (n=3251) were identified with cough, phlegm and/or mucus plugs and ~25% of patients (n=1112) had neither cough or phlegm, nor mucus plugs7
*Based on data from 4363 patients who previously smoked or with active tobacco use with the full spectrum of COPD severity. Patients were recruited from the COPDGene study, with available COPD and CT scan data15; †Included patients with both dry and productive cough7
Z4-86369 | Date of preparation: August 2026
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