BACKGROUND: The COPD Assessment Test (CAT) has been proposed to help guide therapy in chronic obstructive pulmonary disease (COPD). It is important to understand the distribution of scores in different COPD populations and their determinants. METHODS: The POPE study is an international, observational cross-sectional study of COPD subjects in 11 Central and Eastern European countries aimed at characterizing COPD phenotypes. Here we report the analysis of CAT scores with the objective of identifying their determinants, evaluating symptom load and investigating the distribution of scores among the participating countries. Additionally, we investigated the discrepancies between the CAT and modified Medical Research Council (mMRC) scores when used to classify patients according to the GOLD strategy. RESULTS: The study included 3452 patients (69.2% men, mean forced expiratory volume in 1 s (FEV1% predicted) 52.5%). The mean CAT score was 17.5 (SD = 7.8), ranging from 15.1 in Hungary to 21.2 in Bulgaria. Multiple linear regression analysis showed six variables significantly associated with CAT scores: depression, number of previous exacerbations, 6-min walking distance, FEV1(%), mMRC and country and explained 47.2% of the variance of CAT. According to either CAT or mMRC, up to 23.9% patients would be classified in different GOLD groups. CONCLUSIONS: The CAT score may be predicted by factors related to COPD severity, depression and exercise capacity, with significant differences in the distribution of CAT scores in different countries. According to our results CAT >10 is not equivalent to mMRC >2 for assessing symptom burden. TRIAL REGISTRATION: ClinicalTrials.gov, identifier NCT02119494.
- MeSH
- chronická obstrukční plicní nemoc diagnóza epidemiologie patofyziologie terapie MeSH
- deprese epidemiologie MeSH
- fyzická vytrvalost fyziologie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- prevalence MeSH
- průřezové studie MeSH
- respirační funkční testy metody MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- test chůzí metody MeSH
- určení symptomu metody MeSH
- usilovný výdechový objem fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Bulharsko MeSH
- Maďarsko MeSH
- východní Evropa MeSH
COPD is a complex, heterogeneous condition. Even in the early clinical stages, COPD carries a significant burden, with breathlessness frequently leading to a reduction in exercise capacity and changes that correlate with long-term patient outcomes and mortality. Implementation of an effective management strategy is required to reduce symptoms, preserve lung function, quality of life, and exercise capacity, and prevent exacerbations. However, current clinical practice frequently differs from published guidelines on the management of COPD. This review focuses on the current scientific evidence and expert opinion on the management of moderate COPD: the symptoms arising from moderate airflow obstruction and the burden these symptoms impose, how physical activity can improve disease outcomes, the benefits of dual bronchodilation in COPD, and the limited evidence for the benefits of inhaled corticosteroids in this disease. We emphasize the importance of maximizing bronchodilation in COPD with inhaled dual-bronchodilator treatment, enhancing patient-related outcomes, and enabling the withdrawal of inhaled corticosteroids in COPD in well-defined patient groups.
- MeSH
- agonisté beta-2-adrenergních receptorů aplikace a dávkování škodlivé účinky MeSH
- antagonisté muskarinových receptorů aplikace a dávkování škodlivé účinky MeSH
- aplikace inhalační MeSH
- bronchodilatancia aplikace a dávkování škodlivé účinky MeSH
- chronická obstrukční plicní nemoc diagnóza farmakoterapie patofyziologie MeSH
- hormony kůry nadledvin aplikace a dávkování škodlivé účinky MeSH
- kvalita života MeSH
- lidé MeSH
- obnova funkce MeSH
- plíce účinky léků patofyziologie MeSH
- progrese nemoci MeSH
- rizikové faktory MeSH
- stupeň závažnosti nemoci MeSH
- tolerance zátěže účinky léků MeSH
- výsledek terapie MeSH
- zdravotní stav MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Chronic obstructive pulmonary disease (COPD) represents a major health problem in Central and Eastern European (CEE) countries; however, there are no data regarding clinical phenotypes of these patients in this region.Participation in the Phenotypes of COPD in Central and Eastern Europe (POPE) study was offered to stable patients with COPD in a real-life setting. The primary aim of this study was to assess the prevalence of phenotypes according to predefined criteria. Secondary aims included analysis of differences in symptom load, comorbidities and pharmacological treatment.3362 patients with COPD were recruited in 10 CEE countries. 63% of the population were nonexacerbators, 20.4% frequent exacerbators with chronic bronchitis, 9.5% frequent exacerbators without chronic bronchitis and 6.9% were classified as asthma-COPD overlap. Differences in the distribution of phenotypes between countries were observed, with the highest heterogeneity observed in the nonexacerbator cohort and the lowest heterogeneity observed in the asthma-COPD cohort. There were statistically significant differences in symptom load, lung function, comorbidities and treatment between these phenotypes.The majority of patients with stable COPD in CEE are nonexacerbators; however, there are distinct differences in surrogates of disease severity and therapy between predefined COPD phenotypes.
- MeSH
- bronchitida komplikace diagnóza MeSH
- chronická bronchitida komplikace MeSH
- chronická obstrukční plicní nemoc komplikace diagnóza patofyziologie MeSH
- fenotyp MeSH
- komorbidita MeSH
- kouření epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mezinárodní spolupráce MeSH
- poruchy vyvolané užíváním tabáku komplikace diagnóza MeSH
- prevalence MeSH
- průřezové studie MeSH
- sběr dat MeSH
- senioři MeSH
- usilovný výdechový objem MeSH
- vitální kapacita MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
- MeSH
- chronická obstrukční plicní nemoc klasifikace epidemiologie MeSH
- fenotyp MeSH
- lidé MeSH
- průřezové studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- dopisy MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- východní Evropa epidemiologie MeSH
