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Observational Study
. 2024 May 23:19:1123-1130.
doi: 10.2147/COPD.S455397. eCollection 2024.

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 Matsunaga  1
Affiliations
Observational Study

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

Tasuku Yamamoto et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: 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; gender difference; observational study; subjective symptoms.

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Conflict of interest statement

Prof. Dr. Tomoyuki Kakugawa is an employee of the Department of Pulmonology and Gerontology, Graduate School of Medicine, Yamaguchi University, Ube, Japan, which is funded by the Medical Corporation, WADOKAI. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Proportion of each grade of mMRC and exacerbation frequency by sex. The exacerbation frequency was expressed as the percentage of instances where exacerbations occurred two or more times within the past year for each mMRC grade. Female patients were more likely to have a higher mMRC grade, and females exhibited higher exacerbation frequencies even at relatively lower mMRC grades, resulting in an overall higher observed rate of exacerbation events compared to males. mMRC, modified medical research council dyspnea scale.
Figure 2
Figure 2
The percentage of female patients within each group of the GOLD ABCD classification (A) and ABE classification (B). The percentage of female patients was 11.4% in the overall cohort, 8.8% in group A, 12.6% in group B, 12.9% in group C, 18.8% in group D, and 17.6% in group E. The proportion of female patients increased in the more severe group. Female patients were more affected by the disease than male patients in terms of subjective symptoms and number of exacerbations.
See this image and copyright information in PMC

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