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

Int J Chron Obstruct Pulmon Dis. 2024 May 23:19:1123-1130. doi: 10.2147/COPD.S455397. eCollection 2024.

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.

Publication types

  • Multicenter Study
  • Observational Study
  • Comparative Study

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Aged, 80 and over
  • Bronchodilator Agents / therapeutic use
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Forced Expiratory Volume
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Japan / epidemiology
  • Lung* / drug effects
  • Lung* / physiopathology
  • Male
  • Middle Aged
  • Oxygen Inhalation Therapy
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive* / diagnosis
  • Pulmonary Disease, Chronic Obstructive* / epidemiology
  • Pulmonary Disease, Chronic Obstructive* / physiopathology
  • Pulmonary Disease, Chronic Obstructive* / therapy
  • Risk Factors
  • Sex Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Treatment Outcome
  • Vital Capacity

Substances

  • Adrenal Cortex Hormones
  • Bronchodilator Agents