A UK study revealed that the COPD Assessment Test (CAT) can accurately evaluate exacerbation severity in individuals with chronic obstructive pulmonary disease (COPD). The study is published online ahead of print publication in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. Dr. Alex J Mackay, MBBS, MRCP, clinical research member at the Academic Unit of Respiratory Medicine, University College London, explained:
“There is currently no widely accepted standardized method for assessing symptom severity at exacerbations in COPD patients. Incorporating CAT scores into the assessment of COPD patients may provide a standardized objective method for assessing symptom severity in both clinical practice and clinical trials.”
The eight-item CAT questionnaire (a validated health status questionnaire) was completed by 161 COPD patients, who were under supervision at least once at the clinic, and by 75 patients during 152 treated COPD exacerbations.
Prior studies have successfully used the CAT to measure COPD symptoms in both primary and secondary care settings. CAT includes questions evaluated phlegm, activity limitations, cough, chest tightness, sleep, energy levels and breathlessness.
Participants who experienced frequent exacerbations (≥2 exacerbations per year) had considerably higher baseline CAT scores than patients with infrequent exacerbations.
In the 152 exacerbations evaluated, CAT scores increased considerably from an average baseline value of 19.4±6.8, to a value of 24.1±7.3 at exacerbation. CAT score from baseline to exacerbation onset were weak and considerably associated to change in CRP, but not to change in fibrinogen. Furthermore, the team found increases in CAT score at exacerbation were considerably linked to decreases in forced expiratory volume in one second (FEV1). Using symptom diary cards, the researchers determined median recovery time was considerably associated to the time required for CAT scores to return to baseline.
Dr. Mackay, explained: “In our patients with COPD, CAT scores reflected exacerbation severity, as measured by both exacerbation length and reduction in lung function. CAT scores at exacerbation were also weakly related to systemic inflammatory markers and were elevated in stable patients with a history of frequent exacerbations. Our results indicate that the CAT can be used as a score of the multi-dimensional nature of COPD exacerbation severity.” He concluded:
“The CAT is validated, free, and easy to administer, and can be easily incorporated into the usual care of patients with COPD at no additional cost. It may also be useful in clinical trials as an objective measure of new interventions aimed at reducing exacerbation severity. Since our results indicate that CAT scores may reflect levels of systemic inflammatory markers, albeit weakly, this finding may have particular relevance in clinical trials of anti-inflammatory therapeutic agents in COPD.”
Written By Grace Rattue