Characteristics of GOLD 2017 COPD Group A: A Multicenter Cross-Sectional CAP Study in Japan

Oishi, K; Hirano, Tsunahiko; Hamada, Kazuki; Uehara, Sho; Suetake, Ryo; Yamaji, Yoshikazu; Ito, Katsuyoshi; Asami‐Noyama, Maki; Edakuni, Nobutaka; Yano, Masafumi; Matsunaga, Kazumasa

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3283

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…In this study, we found that patients in Groups B and D were older. A similar result was observed in Oishi et al 17 Smoking is a major environmental risk factor for COPD. 18 In this study, we found that Group D had more Ex-smokers and fewer current-smokers compared to Groups A, B and C. Liu et al 19 found the same results and patients with more symptoms are more likely to quit smoking.…”

Section: Discussionsupporting

confidence: 88%

The Characteristics of Airflow Limitation and Future Exacerbations in Different GOLD Groups of COPD Patients

Song¹,

Zhao²,

Zeng³

et al. 2021

COPD

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Background:The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 separated pulmonary function from combined assessment. We aimed to analyze the characteristics of airflow limitation and future exacerbations in different GOLD groups of chronic obstructive pulmonary disease (COPD) patients. Methods: For this prospective observational study, stable COPD outpatients were enrolled and divided into Groups A, B, C and D based on GOLD 2017, and followed-up for 18 months. Data on demographics, pulmonary function, COPD assessment test (CAT), Clinical COPD Questionnaire (CCQ), modified Medical Research Council (mMRC), exacerbations, mortality and treatments were collected. A post-bronchodilator ratio of forced expiratory volume in one second to forced vital capacity <0.70 confirms the presence of airflow limitation. Results: A total of 993 subjects were classified into Groups A (n = 170, 17.1%), B (n = 360, 36.3%), C (n = 122, 12.3%), and D (n = 341, 34.3%). There were significant differences in mMRC, CAT, CCQ, exacerbations and hospitalizations rates among the different groups (P < 0.001). Groups B and D had more severe airflow limitation than Groups A and C (P < 0.05).In the same groups with different severity of airflow limitation, the differences were mainly observed in body mass index, CAT, CCQ and treatment with long-acting muscarinic antagonist (LAMA) and LAMA + long-acting β2-agonist + inhaled corticosteroid (P < 0.05). After 18 months of follow-up, the exacerbations and hospitalizations rates were significantly different among different groups (P < 0.05). However, in the same groups with different airflow limitation severity, the mortality rates and number of exacerbations, hospitalizations and frequent exacerbators showed no differences. Conclusion:In the GOLD groups, different severity of airflow limitation had no impact on future exacerbations and mortality rate. It implies that pulmonary function is not a good indicator for predicting exacerbation.

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Section: Discussionsupporting

confidence: 88%

The Characteristics of Airflow Limitation and Future Exacerbations in Different GOLD Groups of COPD Patients

Song¹,

Zhao²,

Zeng³

et al. 2021

COPD

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“…In this study, stable COPD outpatients were divided into Groups A, B, C, and D based on GOLD 2017 to analyze the clinical features, the characteristics of air ow obstruction and its association with treatment response in the real world. We found that patients were older in Groups B and D. A similar result was observed in Oishi et al [16] Smoking is a major environmental risk factors for COPD [17]. In this study, we found that compared with Group D, there were more current smoker in Groups A, B and C. Perhaps patients in Group D experienced more symptoms, which made more patients stop smoking.…”

Section: Discussionsupporting

confidence: 88%

The characteristics of airflow obstruction and its association with treatment response in the real world in different GOLD groups of COPD patients

Song

Zhao

Zeng

et al. 2021

Preprint

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Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 separated spirometry from combined assessment to guide treatment. We aimed to analyze the characteristics of airflow obstruction and its association with treatment response in the real world in different GOLD groups of COPD patients. Methods: For this prospective observational study, stable COPD outpatients were enrolled and divided into Groups A, B, C and D based on GOLD 2017, and followed-up for 18 months. Data on patient demographics, pulmonary function, COPD assessment test (CAT), Clinical COPD Questionnaire (CCQ), modified Medical Research Council (mMRC), exacerbations, mortality and treatments were collected to analyze the airflow obstruction and its association with treatment response. Results: A total of 993 subjects were classified into Groups A (n = 170, 17.1%), B (n = 360, 36.3%), C (n = 122, 12.3%), and D (n = 341, 34.3%). There were significant differences in mMRC, CAT, CCQ, exacerbations and hospitalizations among different groups (P < 0.001). Groups B and D had more airflow obstruction and ventilatory disorder than Groups A and C (P < 0.05). In the same groups with different GOLD grades, the differences were mainly observed in BMI, CAT, CCQ and treatment with long-acting muscarinic antagonist (LAMA) and LAMA + long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS) (P < 0.05). After 18 months of follow-up, the number of exacerbations and hospitalizations were significantly different among different groups, with Group D having the highest values. Also, there were more frequent exacerbators and a higher mortality rate in Group D. However, in the same groups with different GOLD grades, the mortality rates and number of exacerbations, hospitalizations and frequent exacerbators showed no differences. Conclusion: There were significant differences in pulmonary function in different groups. However, different GOLD grades had no impact on future exacerbations and mortality rate in the same groups.

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“…In a real-world survey, most COPD patients belonged to GOLD A or B, who are less likely to experience exacerbations but continue to have daily symptoms [ 86 , 87 ]. Therefore, knowledge concerning the effects of ICS other than preventing exacerbations, such as increased lung function and improvement of symptoms, are also required.…”

Section: Existent Type2 Biomarkers In Copdmentioning

confidence: 99%

Role of Type2 Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

Oishi

Matsunaga

Shirai

et al. 2020

JCM

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Airway inflammation in chronic obstructive pulmonary disease (COPD) is typically thought to be driven by Type1 immune responses, while Type2 inflammation appears to be present in definite proportions in the stable state and during exacerbations. In fact, some COPD patients showed gene expression of Type2 inflammation in the airway, and this subset was associated with the inhaled corticosteroid (ICS) response. Interestingly enough, the relationship between COPD and diseases associated with Type2 inflammation from the perspective of impaired lung development is increasingly highlighted by recent epidemiologic studies on the origin of COPD. Therefore, many researchers have shown an interest in the prevalence and the role of existent Type2 biomarkers such as sputum and blood eosinophils, exhaled nitric oxide fraction, and atopy, not only in asthma but also in COPD. Although the evidence about Type2 biomarkers in COPD is inconsistent and less robust, Type2 biomarkers have shown some potential when analyzing various clinical outcomes or therapeutic response to ICS. In this article, we review the existent and emerging Type2 biomarkers with clinically higher applicability in the management of COPD.

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Characteristics of GOLD 2017 COPD Group A: A Multicenter Cross-Sectional CAP Study in Japan

Cited by 4 publications

References 12 publications

The Characteristics of Airflow Limitation and Future Exacerbations in Different GOLD Groups of COPD Patients

The Characteristics of Airflow Limitation and Future Exacerbations in Different GOLD Groups of COPD Patients

The characteristics of airflow obstruction and its association with treatment response in the real world in different GOLD groups of COPD patients

Role of Type2 Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

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