CAT score single item analysis in patients with COPD: results from COSYCONET

Siemens, M; Alter, Peter; Lutter, Johanna I.; Kauczor, HU; Jobst, BJ; Bals, Robert; Trudzinski, F; Söhler, Sandra; Behr, Jürgen; Watz, Henrik; Waschki, Benjamin; Bewig, Burkhard; Jones, P. W.; Welte, Tobias; Vogelmeier, Claus; Jörres, RA; Kahnert, Kathrin

doi:10.1055/s-0039-3403209

Cited by 9 publications

(16 citation statements)

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“…Overall, baseline demographic characteristics as well as lung function impairment status (measured by FEV 1 ) and the distribution of GOLD stages and groups of the study population were largely comparable to other German COPD cohorts. [36][37][38] The total CAT at baseline was higher compared to other German cohorts, 36,37 indicating the need for additional pharmacological intervention.…”

Section: Discussionmentioning

confidence: 88%

Effectiveness of Extrafine Single Inhaler Triple Therapy in Chronic Obstructive Pulmonary Disease (COPD) in Germany – The TriOptimize Study

Geßner¹,

Javan²,

Hövelmann³

et al. 2022

COPD

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Purpose Real-word evidence on the effectiveness of switching from dual therapies or triple therapies (multiple inhalers) to extrafine single-inhaler triple therapy (efSITT), which consists of the inhaled corticosteroid (ICS) beclomethasone, the long-acting β 2 -agonist (LABA) formoterol and the long-acting muscarinic antagonist (LAMA) glycopyrronium, in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) is limited. The impact of switching to efSITT on health-related quality of life (HRQoL), COPD specific symptoms, lung function and treatment adherence were assessed in routine clinical care. Patients and Methods Patients were recruited at 148 sites in Germany between 2017 and 2020 in this multicenter, non-interventional observational study. Demographics, clinical data and treatment history were collected at baseline. HRQoL (measured by COPD Assessment Test [CAT]), lung function and adherence (measured by Test of Adherence to Inhalers [TAI]) were assessed at baseline and after six months. Descriptive analyses were conducted by prior treatment and GOLD groups as well as for the overall population. Results 55.1% of the 2623 included patients were male. Mean age was 65.8 years. 57.5% of the patients were previously treated with ICS+LABA+LAMA (multiple inhalers), 23.9% with ICS/LABA (single or two inhalers) and 18.6% with LAMA/LABA (single or two inhalers). After six months, largest mean improvements in the total CAT score were observed in the ICS/LABA (−3.9) and LAMA/LABA (−3.9) prior treatment groups as well as in patients in GOLD group B (−2.9). In the overall population, the CAT items for cough, phlegm, and dyspnea decreased on average by −0.4 points each. After six months, FEV 1 increased by 2.0 percentage points in relation to predicted values. The percentages of measured sRtot and RV of predicted values decreased by 24.5 and 4.4 percentage points, respectively. The percentage of patients with good adherence increased from 67.8% to 76.5%. Conclusion Treatment switch to efSITT resulted in an improvement of HRQoL, COPD specific symptoms, lung function parameters and adherence under real-world conditions.

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Section: Discussionmentioning

confidence: 88%

Effectiveness of Extrafine Single Inhaler Triple Therapy in Chronic Obstructive Pulmonary Disease (COPD) in Germany – The TriOptimize Study

Geßner¹,

Javan²,

Hövelmann³

et al. 2022

COPD

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“…[15][16][17] Recent studies have shown that each CAT item contains additional information and contributes differently to the total score. [18][19][20] However, to the best of our knowledge, there are a few data primarily focusing on changes in each CAT item after bronchodilator therapy initiation and its association with other clinical factors. Thus, we investigated changes in individual CAT scores after shortterm bronchodilator therapy among treatmentnaïve patients with COPD and compared lung function, mMRC dyspnea, and exacerbations between patients whose CAT scores improved and those whose CAT scores did not.…”

Section: Introductionmentioning

confidence: 99%

Change in individual chronic obstructive pulmonary disease assessment test item scores after short-term bronchodilator therapy and its impact on exacerbation in treatment-naïve patients with chronic obstructive pulmonary disease

Kim

Shin

Gil

et al. 2022

Therapeutic Advances in Chronic Disease

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Background: The chronic obstructive pulmonary disease (COPD) assessment test (CAT) measures the health status of patients with COPD. We aimed to investigate the change in individual CAT scores after short-term bronchodilator therapy among treatment-naïve patients with COPD. Methods: Data from 148 patients newly diagnosed with COPD between January 2016 and April 2020 were retrospectively analyzed. We compared the CAT score, modified Medical Research Council (mMRC) dyspnea grade, and forced expiratory volume in 1 s (FEV1) before and after short-term (6 ± 2 months) bronchodilator therapy. We analyzed the change trends using generalized estimating equations. Results: The mean patient age was 70.9 years, and 92.6% were male. The total CAT score did not significantly improve. However, among the CAT items, phlegm [adjusted difference: –0.22 (–0.48, –0.002)], chest tightness [–0.30 (–0.56, –0.05)], and breathlessness [–0.45 (–0.66, –0.23)] scores significantly improved after bronchodilator therapy. The patients were divided into two groups: CAT score improved ( n = 69) and not improved group ( n = 79). The development of moderate-to-severe exacerbations during follow-up was significantly lower (2.9% versus 17.7%, p = 0.004) in the CAT score improved group. Conclusion: The improvement in CAT items indicating respiratory symptoms was more evident than the CAT total score after short-term bronchodilator therapy. Despite the significant increase in FEV1 after bronchodilator therapy, fewer than half of the patients achieved meaningful improvement in CAT, and this group showed significantly lower development of exacerbation during follow-up.

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“…Differences in functional measures, comorbidities and symptoms between men and women with COPD have been described in many studies [4,5], particularly with regard to cardiac comorbidities, sleep apnea, asthma and osteoporosis, and to COPD symptoms such as cough and phlegm []. We quantified symptoms via the single CAT items, since we had found that these carried more information on COPD characteristics than the total score [8]. Indeed, the inspection of Fig.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of comorbidities is of importance for the clinical course and treatment of COPD [1]. Noteworthy, some information on comorbidities and COPD phenotypes can be derived from simple information such as the categorization into GOLD groups, or the modified Medical Research Council (mMRC) scale, or single questions of the COPD Assessment Test (CAT) [8][9][10]. The fact that symptoms of cardiac disease and COPD show significant overlap, renders it difficult to get clues on cardiac disorders from symptoms alone.…”

Section: Introductionmentioning

confidence: 99%

Gender-specific differences in COPD symptoms and their impact for the diagnosis of cardiac comorbidities

et al. 2021

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Background In chronic obstructive pulmonary disease (COPD), gender-specific differences in the prevalence of symptoms and comorbidity are known. Research question We studied whether the relationship between these characteristics depended on gender and carried diagnostic information regarding cardiac comorbidities. Study design and methods The analysis was based on 2046 patients (GOLD grades 1–4, 795 women; 38.8%) from the COSYCONET COPD cohort. Assessments comprised the determination of clinical history, comorbidities, lung function, COPD Assessment Test (CAT) and modified Medical Research Council dyspnea scale (mMRC). Using multivariate regression analyses, gender-specific differences in the relationship between symptoms, single CAT items, comorbidities and functional alterations were determined. To reveal the relationship to cardiac disease (myocardial infarction, or heart failure, or coronary artery disease) logistic regression analysis was performed separately in men and women. Results Most functional parameters and comorbidities, as well as CAT items 1 (cough), 2 (phlegm) and 5 (activities), differed significantly (p < 0.05) between men and women. Beyond this, the relationship between functional parameters and comorbidities versus symptoms showed gender-specific differences, especially for single CAT items. In men, item 8 (energy), mMRC, smoking status, BMI, age and spirometric lung function was related to cardiac disease, while in women primarily age was predictive. Interpretation Gender-specific differences in COPD not only comprised differences in symptoms, comorbidities and functional alterations, but also differences in their mutual relationships. This was reflected in different determinants linked to cardiac disease, thereby indicating that simple diagnostic information might be used differently in men and women. Clinical trial registration The cohort study is registered on ClinicalTrials.gov with identifier NCT01245933 and on GermanCTR.de with identifier DRKS00000284, date of registration November 23, 2010. Further information can be obtained on the website http://www.asconet.net.

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CAT score single item analysis in patients with COPD: results from COSYCONET

Cited by 9 publications

References 0 publications

Effectiveness of Extrafine Single Inhaler Triple Therapy in Chronic Obstructive Pulmonary Disease (COPD) in Germany – The TriOptimize Study

Effectiveness of Extrafine Single Inhaler Triple Therapy in Chronic Obstructive Pulmonary Disease (COPD) in Germany – The TriOptimize Study

Change in individual chronic obstructive pulmonary disease assessment test item scores after short-term bronchodilator therapy and its impact on exacerbation in treatment-naïve patients with chronic obstructive pulmonary disease

Gender-specific differences in COPD symptoms and their impact for the diagnosis of cardiac comorbidities

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