The relationship between the COPD Assessment Test score and airflow limitation in Japan in patients aged over 40 years with a smoking history

Abstract

BackgroundA large number of chronic obstructive pulmonary disease (COPD) patients in Japan remain undiagnosed, primarily due to the underuse of spirometry. Two studies were conducted to see whether the COPD Assessment Test (CAT) in primary care has the potential to identify those patients who need spirometry for a diagnosis of COPD and to determine whether patients with cardiovascular disease had airflow limitation, which could be detected by CAT.Materials and methodsTwo multicenter, noninterventional, prospective studies (studies 1 and 2) were conducted across Japan. Patients in both studies were ≥40 years old with a smoking history. Those in study 1 were seen in primary care and had experienced repeated respiratory tract infections, but had no diagnosis of COPD. Patients in study 2 were identified in cardiovascular disease clinics when routinely visiting for their cardiovascular disease. All patients completed the CAT prior to lung-function testing by hand-held spirometry. The presence of airflow limitation was defined as a forced expiratory volume in 1 second (FEV1)/FEV6 ratio <0.73.ResultsA total of 3,062 subjects completed the CAT (2,067 in study 1, 995 in study 2); 88.8% were male, and the mean age (± standard deviation) was 61.5±11.6 years. Airflow limitation was found in 400 (19.4%) patients in study 1, and 269 (27.0%) in study 2. The CAT score in patients with airflow limitation was significantly higher than in patients without airflow limitation in both studies: 8.6 (95% confidence interval [CI] 7.9–9.2) versus 7.4 (95% CI 7.1–7.6) in study 1, and 8.3 (95% CI 7.5–9.2) versus 6.4 (95% CI 6.0–6.8) in study 2 (both P<0.001).ConclusionThese findings suggest that the CAT has the potential to identify patients with cardiovascular disease or a history of frequent chest infections who need spirometry to diagnose COPD.

COPD assessment test and severity of airflow limitation in patients with asthma, COPD, and asthma&ndash;COPD overlap syndrome

“…Several studies have reported the CAT scores as a screening tool for COPD in a general population. 14 , 22 However, this study showed that the elevated CAT scores are not disease specific, but the patterns of elevated CAT components might be more useful to characterize these diseases. Elevated exertional dyspnea score compared to other components was observed in patients with COPD and ACOS, suggesting the presence of persistent airflow limitation.…”

“… 12 , 13 The CAT score has been shown to be useful to identify subjects who require spirometry for the diagnosis of airflow limitation. 14 In contrast to the asthma control test (ACT), which asks about asthma-specific symptoms and reliever use, 15 the CAT score consists of eight nonspecific questions about disease impacts.…”

The distribution of blood eosinophil levels in a Japanese COPD clinical trial database and in the rest of the world

“…The greater predominance of older Japanese male COPD patients is typical of other Japanese studies in clinical settings. 26 – 28 However, the data from the Japanese population in the current study show that, despite the exclusion of patients with asthma, a proportion of patients have high eosinophil counts. Of note, one included study (the Japanese COSMOS-J trial; Table S1 ), 18 of 400 patients with COPD, did not exclude patients with asthma.…”

Different Pattern of Chronic Obstructive Pulmonary Disease Assessment Test Score between Chronic Bronchitis and Non-chronic Bronchitis Patients

“…Pothirat et al 14 showed change in CAT score was valid to detect acute exacerbation. Yoshimoto et al 15 suggested CAT score was related with airflow limitation. Sarioglu et al 16 demonstrated CAT score was associated with systemic inflammatory marker.…”