Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2018 Dec 5:13:3901-3907.
doi: 10.2147/COPD.S181938. eCollection 2018.

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 Matsunaga  2
Affiliations
Comparative Study

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

Keiji Oishi et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: The 2017 GOLD ABCD classification shifts patients from groups C-D to A-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-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 β-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 β-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-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; exacerbation; mMRC.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Distribution of the 2015 GOLD and 2017 GOLD ABCD classification when stratifying group A according to the mMRC grade and exacerbation history. Note: The 2017 GOLD classification significantly increased the proportion of patients in groups A and B, while it decreased the proportion of patients in groups C and D. Abbreviation: Ex, exacerbation.
Figure 2
Figure 2
The proportion of group A according to the severity of airflow limitation. Note: The more severe the airflow limitation was, the lower the proportion of group A. Abbreviation: CAP, COPD Assessment in Practice.
Figure 3
Figure 3
Differences in the airflow limitation and exacerbation risk in accordance with the categories of mMRC grade 0 in group A, mMRC grade 1 in group A, group A, and groups B–D. Notes: (A) Significant differences in %FEV1 were found. (B) Regarding the proportion of patients with exacerbations, a significant difference between group A and groups B–D was found, and a difference between mMRC grades 0 and 1 in group A was found. Abbreviation: CAP, COPD Assessment in Practice.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. National Institute for Health and Clinical Excellence (NICE) NICE Guidelines [CG101] London: NICE; 2010. Chronic obstructive pulmonary disease in over-16s: diagnosis and management. - PubMed
    1. Fukuchi Y, Nishimura M, Ichinose M, et al. COPD in Japan: the Nippon COPD Epidemiology study. Respirology. 2004;9(4):458–465. - PubMed
    1. Buist AS, Mcburnie MA, Vollmer WM, et al. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007;370(9589):741–750. - PubMed
    1. From the Global Strategy for the Diagnosis, Management and Prevention of COPD Global Initiative for Chronic Obstructive Lung Disease. 2017. [Accessed July 30, 2018]. Available from: http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-preve....
    1. Cabrera López C, Casanova Macario C, Marín Trigo JM, et al. Comparison of the 2017 and 2015 global initiative for chronic obstructive lung disease reports. Impact on grouping and outcomes. Am J Respir Crit Care Med. 2018;197(4):463–469. - PubMed

MeSH terms

Substances