How Frequently Do Patients With COPD Experience Control Status Changes?

Individuals with chronic obstructive pulmonary disease (COPD) experience significantly more frequent changes in their control status than in their phenotype, risk level, or Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, according to results of a new study.

In fact, nearly one-third of the 354 patients included in the study experienced changes in their control status in only 3 months. These changes resulted in significant changes to the patients’ health status, according to the researchers.

To reach these conclusions, the researchers compared changes in control over a 3-month period with changes in risk level, GOLD stage, and clinical phenotype (including nonexacerbator, asthma-COPD overlap, or exacerbator with emphysema or with chronic bronchitis).

“Control was defined as the presence of low clinical impact, assessed according to the degree of dyspnea, use of rescue medication, physical activity and sputum color, and clinical stability assessed by clinical changes and exacerbations in the last 3 months,” the researchers wrote. “Impact and stability were alternatively assessed with COPD Assessment Test (CAT) scores.”

The 354 patients had a mean forced expiratory volume in 1 second of 49.8% ± 16.9%.

Based on clinical evaluation, the proportion of controlled patients was 50.3% at month 3. And based on CAT score, the proportion of controlled patients was 47.8% at month 3.

As assessed by clinical variables, 87 patients (29.2%) had experienced a change in their control status. And according to CAT score, 85 patients (28.5%) had experienced a change in their control status.

Meanwhile, 26 patients (8.7%) had a change in risk level, 27 patients (9.1%) had a change in their clinical phenotype, and 59 patients (19.8%) had a change in their GOLD stage. 

Patients who showed an improvement in control status had better CAT scores at the end of follow-up.

—Colleen Murphy

Reference:

Soler-Cataluña JJ, Alcázar B, Marzo M, Pérez J, Miravitlles M. Evaluation of changes in control status in COPD: an opportunity for early intervention. CHEST. 2020;157(5):1138-1146. doi:10.1016/j.chest.2019.11.004