Recent studies have demonstrated a positive correlation between blood eosinophil count in COPD patients and the magnitude of response to ICS in terms of exacerbation [2]. As Prof. Mona Bafadhel (University of Oxford, United Kingdom) pointed out, current GOLD guidelines recommend using blood eosinophil counts to assist clinicians in predicting the likelihood of beneficial response to ICS [3]. As there is a high intra-individual variation of eosinophils, it is not clear how many eosinophil measurements are sufficient to predict ICS response in COPD.
In their study, Prof. Bafadhel and colleagues used data from the IMPACT trial. In this trial, the magnitude of benefit of regimens containing ICS (i.e. the triple combination fluticasone furoate, umeclidinium, and vilanterol) in reducing rates of exacerbation increased in proportion with blood eosinophil counts compared with a non-ICS, dual, long-acting bronchodilator [4]. The current analysis assessed whether 1 or 2 measurements of eosinophils is sufficient to predict ICS response [1].
All 5 blood eosinophil count measurements assessed in the IMPACT trial predicted response to ICS, even when considering different covariates (e.g. exacerbation history). However, the best fitting model was the blood eosinophil count measured at study randomisation.
As Prof. Bafadhel concluded, according to this analysis of the IMPACT trial, a second blood eosinophil count measurement appears not to provide additional information to predict ICS exposure in COPD versus a single value.
- Bafadhel M, et al. Abstract 1358, ERS 2019, 29 Sept-2 Oct, Madrid, Spain.
- Pascoe S, et al. Lancet Respir Med 2018;6(5):e18.
- Global Initiative of Chronic Obstructive Lung Disease. 2019 Report. Retrieved from https://goldcopd.org (accessed on 30 Sept 2019).
- Pascoe S, et al. Lancet Respir Med 2019;7(9):745-56.
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Table of Contents: ERS 2019
Featured articles
Letter from the Editor
Interview with ERS president Prof. Tobias Welte
Holistic View on Asthma
Holistic view on asthma
COPD Management
COPD patients derive clinical benefit from β-blockers
COPD patients harbouring Pseudomonas Aeruginosa face high risk of hospitalisation
One blood eosinophil count is sufficient to guide ICS therapy
Female COPD patients frequently suffer from anxiety and depression
Dual bronchodilation improves ventilation dynamics in COPD patients
Vaping
Vaping impairs innate immune response of the airway
Alternative nicotine delivery products: no help in smoking cessation
Air Pollution
Pregnant women and their offspring: a high-risk group for air pollution
Taxi drivers exposed to highest levels of black carbon pollution
Infectious Respiratory Disease: the Role of Vaccines
Vaccines show multiple positive effects with respect to respiratory health
Pneumococcal vaccines: an effective way to reduce COPD hospitalisations
Interstitial Lung Disease
Antifibrotic therapy slows disease progression in ILD
Reduction of FVC decline in systemic sclerosis-associated ILD
Registry confirms nintedanib efficacy under real-life conditions
Best of the Posters
Fever during immunotherapy for NSCLC associated with shorter PFS
Smart shirt as a device to measure tidal volumes in real-life setting
Exercise with virtual reality beneficial for COPD patients
NSCLC: A new way to evaluate hilar and mediastinal lymph nodes
COPD patients do not benefit from azithromycin therapy longer than a year
Novel Developments in Infectious Disease
Long-term azithromycin decreases exacerbations in primary ciliary dyskinesia
Predicting community-acquired pneumonia outcomes by microRNA testing
Pulmonary Vascular Disease
Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension
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