Factors associated with the prescription of inhaled corticosteroids in GOLD group A and B patients with COPD – subgroup analysis of the Taiwan obstructive lung disease cohort

Figures & data

Table 1 Demographic characteristics of the study population by 2011 GOLD criteria classification (n=1,096)

Characteristics	Group A	Group B	Group C	Group D
Patient number	179 (16.3%)	398 (36.3%)	99 (9.0%)	420 (38.3%)
Male sex	167 (93.3%)	370 (93.0%)	96 (97.0%)	400 (95.2%)
BMI (kg/m^2)	24.2±3.3	24.0±3.8	23.0±3.6	22.7±3.8
Smoking history
Never	10 (5.8%)	42 (10.9%)	11 (11.3%)	42 (10.3%)
Ex-smoker	88 (51.2%)	217 (56.4%)	58 (59.8%)	245 (60.0%)
Currently smoking	74 (43.0%)	126 (32.7%)	28 (28.9%)	121 (29.7%)
Occupational dust and chemicals	0 (0.0%)	11 (2.8%)	1 (1.0%)	15 (3.6%)
Indoor air pollution from cooking	2 (1.1%)	1 (0.3%)	0 (0.0%)	0 (0.0%)
Outdoor air pollution	15 (8.4%)	15 (3.8%)	7 (7.1%)	20 (4.8%)
Environmental tobacco smoke	11 (6.1%)	16 (4.0%)	2 (2.0%)	15 (3.6%)
2006 GOLD criteria classification
Stage I (N=191)	73 (38.2%)	108 (56.5%)	2 (1.0%)	8 (4.2%)
Stage II (N=459)	106 (23.1%)	290 (63.2%)	10 (2.2%)	53 (11.5%)
Stage III (N=324)	0 (0.0%)	0 (0.0%)	58 (17.9%)	266 (82.1%)
Stage IV (N=122)	0 (0.0%)	0 (0.0%)	29 (23.8%)	93 (76.2%)
CAT score
Available number	179 (100.0%)	397 (99.7%)	99 (100.0%)	419 (99.8%)
Median (quartiles)	5 (3, 7)	12 (7, 16)	6 (3, 8)	14 (10, 20)
CAT category
<10	179 (100.0%)	137 (34.5%)	99 (100.0%)	97 (23.2%)
≥10	0 (0.0%)	260 (65.5%)	0 (0.0%)	322 (76.8%)
mMRC score
Available number	170 (95.0%)	337 (84.7%)	97 (98.0%)	368 (87.6%)
Median (quartiles)	1 (1, 1)	2 (2, 2)	1 (1, 1)	2 (2, 3)
mMRC category
0–1	170 (100.0%)	55 (16.3%)	97 (100.0%)	45 (12.2%)
≥2	0 (0.0%)	282 (83.7%)	0 (0.0%)	323 (87.8%)
AE within past 1 year
Available number	179 (100.0%)	398 (100.0%)	99 (100.0%)	420 (100.0%)
Median (quartiles)	0 (0, 0)	0 (0, 0)	0 (0, 1)	1 (0, 2)
Number of AE within the past 1 year
0	153 (85.5%)	320 (80.4%)	60 (60.6%)	202 (48.1%)
1	26 (14.5%)	78 (19.6%)	21 (21.2%)	88 (21.0%)
≥2	0 (0.0%)	0 (0.0%)	18 (18.1%)	130 (30.9%)
Wheezing	51 (28.5%)	136 (34.2%)	36 (36.4%)	201 (47.9%)

Abbreviations: AE, acute exacerbation; BMI, body mass index; CAT, COPD assessment test; COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease; mMRC, modified Medical Research Council.

Figure 1 The percentages of ICS prescriptions in the different groups of COPD patients.

Abbreviations: COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICS, inhaled corticosteroids.

Table 2 Univariate analysis of demographic characteristics and COPD-related clinical data in group A and B patients

Characteristics	Group A			Group B			Group A and B
	ICS user	No ICS	P-value	ICS user	No ICS	P-value	ICS user	No ICS	P-value
Patient number (%)	54 (30.2%)	125 (69.8%)	<0.001	144 (36.2%)	254 (63.8%)	<0.001	198 (34.3%)	379 (65.7%)	<0.001
Sex (%)
Male	48 (88.9%)	119 (95.2%)	0.189	133 (92.4%)	237 (93.3%)	0.723	181 (91.4%)	356 (93.9%)	0.258
Smoking history (%)
Never	4 (8.0%)	6 (4.9%)	0.578	18 (12.8%)	24 (9.8%)	0.110	22 (11.5%)	30 (8.2%)	0.049
Ex-smoker	27 (54.0%)	61 (50.0%)		86 (61.0%)	131 (53.7%)		113 (59.2%)	192 (52.5%)
Currently smoking	19 (38.0%)	55 (45.1%)		37 (26.2%)	89 (36.5%)		56 (29.3%)	144 (39.3%)
CAT score (%)
Median (quartiles)	6 (4, 8)	5 (3, 7)	0.128	12 (8, 17)	11 (7, 15)	0.038	10 (5, 16)	8 (5, 13)	0.011
<10	54 (100.0%)	125 (100.0%)	NA	43 (29.9%)	94 (37.2%)	0.142	97 (49.0%)	219 (57.9%)	0.040
≥10	0 (0.0%)	0 (0.0%)		101 (70.1%)	159 (62.8%)		101 (51.0%)	159 (42.1%)
mMRC score (%)
Median (quartiles)	1 (1, 1)	1 (1, 1)	0.576	2 (2, 2)	2 (2, 2)	0.274	2 (1, 2)	2 (1, 2)	0.274
<2	51 (100.0%)	119 (100.0%)	NA	18 (15.9%)	37 (16.5%)	0.890	69 (42.1%)	156 (45.5%)	0.470
≥2	0 (0.0%)	0 (0.0%)		95 (84.1%)	187 (83.5%)		95 (57.9%)	187 (54.5%)
Bronchodilator responder (%)
Yes	6 (12.5%)	12 (10.9%)	0.772	17 (12.8%)	23 (11.0%)	0.618	23 (12.7%)	35 (11.0%)	0.560
No	42 (87.5%)	98 (89.1%)		116 (87.2%)	186 (89.0%)		158 (87.3%)	284 (89.0%)
Wheezing (%)
Yes	22 (40.7%)	29 (23.2%)	0.017	63 (43.8%)	73 (28.7%)	0.002	85 (42.9%)	102 (26.9%)	<0.001
No	32 (59.3%)	96 (76.8%)		81 (56.3%)	181 (71.3%)		113 (57.1%)	277 (73.1%)

Note: Bronchodilator responder was defined as an increase of 12% and 200 mL in the FEV₁ or FVC after bronchodilator drug treatment.

Abbreviations: CAT, COPD assessment test; COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in the first second; FVC, forced vital capacity; ICS, inhaled corticosteroids; mMRC, modified Medical Research Council.

Table 3 Multivariate logistic regression model of group A and B COPD patients

Characteristics	Parameter estimate	Standard error	Odds ratio (95% CI)	P-value
Group A
Smoking history: never vs current smoker	0.8260	0.7212	2.28 (0.56, 9.39)	0.252
Wheezing: yes vs no	0.8446	0.3641	2.33 (1.14, 4.75)	0.020
CAT score	0.0740	0.0729	1.08 (0.93, 1.24)	0.310
Group B
Smoking history: never vs current smoker	0.5909	0.3758	1.81 (0.86, 3.77)	0.116
Wheezing: yes vs no	0.6552	0.2248	1.93 (1.24, 2.99)	0.004
CAT score	0.0346	0.0166	1.04 (1.00, 1.07)	0.038
Groups A and B
Smoking history: never vs current smoker	0.6163	0.3293	1.85 (0.97, 3.53)	0.061
Wheezing: yes vs no	0.7109	0.1908	2.04 (1.40, 2.96)	<0.001
CAT score	0.0371	0.0141	1.04 (1.01, 1.07)	0.009

Abbreviations: CI, confidence interval; CAT, COPD assessment test; COPD, chronic obstructive pulmonary disease.