Management Reality of Female Patients with COPD: A Multicenter Cross-Sectional CAP Study in Japan

Tasuku Yamamoto,1,2 Keiji Oishi,1 Syuichiro Ohata,1 Yoriyuki Murata,1 Yoshikazu Yamaji,1 Maki Asami-Noyama,1 Nobutaka Edakuni,1 Tomoyuki Kakugawa,3 Tsunahiko Hirano,1 Kazuto Matsunaga1 1Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan; 2Department of Respiratory Medicine, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Yamaguchi, Japan; 3Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, JapanCorrespondence: Keiji Oishi, Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan, Tel +81 836 85 3123, Fax +81 836 85 3124, Email [email protected]: Reports from Europe and North America suggest that female chronic obstructive pulmonary disease (COPD) patients have a higher symptom burden and mortality than male patients. However, little is known about the management reality of female patients with COPD in Japan.Patients and Methods: We compared the clinical characteristics of female COPD patients with those of male using the cohort of the COPD Assessment in Practice study, which is a cross-sectional multicenter observational study.Results: Of the 1168 patients, 133 (11.4%) were female. A history of never smoking was higher in females than males (p< 0.01). Although there was no difference in age or forced expiratory volume in one second (FEV1) % predicted between the groups, modified medical research council dyspnea scale (mMRC) and number of frequent exacerbators were higher in females (mMRC≥ 2: p< 0.01; number of exacerbations≥ 2: p=0.011). The mean forced vital capacity and FEV1 values in females were lower than those in males (p< 0.0001 and p< 0.0001, respectively). Females were more likely to use long-term oxygen therapy and inhaled corticosteroids than males (p=0.016 and p< 0.01, respectively). The prevalence of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups B, C, D (ABCD GOLD 2017 classification), and E (ABE GOLD 2023 classification) was higher in females than in males.Conclusion: The disease burden of female patients with COPD is higher than that of male patients in Japan, suggesting the importance of interventions considering female-dominant features such as lower absolute FVC and FEV1, respiratory failure, and asthma-like conditions.Keywords: chronic obstructive pulmonary disease, exacerbation, subjective symptoms, gender difference, observational stud

Characteristics of 2017 GOLD COPD group A: a multicenter cross-sectional CAP study in Japan

Keiji Oishi,1 Tsunahiko Hirano,2 Kazuki Hamada,2 Sho Uehara,2 Ryo Suetake,2 Yoshikazu Yamaji,2 Kosuke Ito,2 Maki Asami-Noyama,2 Nobutaka Edakuni,2 Kazuto Matsunaga2 1Department of Medicine and Clinical Science, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan; 2Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi, Japan Purpose: The 2017 GOLD ABCD classification shifts patients from groups C&ndash;D to A&ndash;B. Group A was the most widely distributed group in several studies. It would be useful to understand the characteristics for group A patients, but little has been reported concerning these issues. Patients and methods: This was a multicenter cross-sectional study using the COPD Assessment in Practice study database from 15 primary or secondary care facilities in Japan. We investigated the clinical characteristics of group A by stratification according to a mMRC grade 0 or 1. Results: In 1,168 COPD patients, group A patients accounted for approximately half of the patients. Compared with the groups B&ndash;D, group A was younger and had a higher proportion of males, higher pulmonary function, and higher proportion of monotherapy with long-acting muscarinic antagonist or long-acting &beta;-agonist. The prevalence of mMRC grade 1 patients was about two-thirds of group A. Compared with the mMRC 0 patients, mMRC 1 patients showed a tendency to have a higher proportion of exacerbations (P=0.054) and had a significantly lower pulmonary function. Regardless of the mMRC grade, 60% of group A patients were treated with monotherapy of long-acting muscarinic antagonist or long-acting &beta;-agonist. Conclusion: Group A patients accounted for approximately half of the patients, and they were younger, had higher pulmonary function, and had lower pharmacotherapy intensity compared with groups B&ndash;D. By stratifying according to the mMRC grade 0 or 1 in group A patients, there were differences in the exacerbation risk and airflow limitation. Keywords: COPD, GOLD, mMRC, exacerbatio

Decreased miR122 in hepatocellular carcinoma leads to chemoresistance with increased arginine

10.18632/oncotarget.3234Oncotarget6108339-835