Prospective study of association between step-up of inhaled maintenance therapy and CAT and mMRC scores in patients with stable COPD

<bold>Aim:</bold> To explore the association between COPD Assessment Test (CAT) and modified Medical Research Council (mMRC) scores in patients with stable COPD with a change in maintenance treatment. <bold>Methods:</bold> Stable patients from the PATTERN study were investigated between 2021–2023. CAT and mMRC were assessed at baseline. Patients’ socio-economic level, clinical profile and step-up in inhaled therapy were recorded from baseline with a follow-up of 3 months. <bold>Results:</bold> This study included 797 patients. Mean (SD) age was 67.1 (8.2) years, 88.2% of patients were male, and 54.1% were from tertiary hospitals. Median (IQR) baseline CAT score was 13 (7, 20) and 51.1% of patients had mMRC score of ≤1. A total of 25.2% of patients had an exacerbation in the previous year. A step-up in treatment occurred in 7.7%, 10.1%, 11.4% and 15.4% of patients with CAT scores of ≤10, 11–20, 21–30 and ≥31, respectively. CAT score was positively associated with a step-up in treatment (odds ratio [OR] [95% CI]: 1.03, [1.00-1.06], <italic>P</italic>=0.049), but mMRC score was not (OR [95% CI: 1.11 [0.86-1.44], <italic>P</italic>=0.409). After adjusting for covariates, the association between CAT score and a step-up in treatment was <italic>P</italic>=0.055 (Figure). <bold>Conclusion:</bold> Step-up of maintenance therapy in patients with stable COPD was marginally related to symptom level. The key reason for treatment step-up in these patients remains unclear. Funding: GSK (213550) <fig><object-id>erj;64/suppl_68/PA4794/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>