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. 2018 Nov;27(11):1191-1199.
doi: 10.1002/pds.4655. Epub 2018 Sep 28.

Blood eosinophilia, use of inhaled corticosteroids, and risk of COPD exacerbations and mortality

Olorunfemi A Oshagbemi  1   2   3   4 , Frits M E Franssen  4   5 , Dionne C W Braeken  3   4   5 , Yvonne Henskens  6 , Emiel F M Wouters  4   5 , Anke-Hilse Maitland-van der Zee  3   7 , Andrea M Burden  1   2   3 , Frank de Vries  1   2   8
Affiliations

Blood eosinophilia, use of inhaled corticosteroids, and risk of COPD exacerbations and mortality

Olorunfemi A Oshagbemi et al. Pharmacoepidemiol Drug Saf. 2018 Nov.

Abstract

Purpose: It remains unclear whether eosinophilia is useful for in guiding inhaled corticosteroid (ICS) therapy in chronic obstructive pulmonary disease (COPD) patients. The goal of this study is to evaluate the risk of acute exacerbations, COPD-related hospitalisations/accident and emergency visits, and all-cause mortality with various levels of eosinophil counts among COPD patients using ICS.

Methods: A cohort study was conducted using the UK Clinical Practice Research Datalink. Patients were aged 40+ and had COPD (n = 32 693). Current users of ICS were stratified by relative and absolute eosinophil counts to determine the risk of outcomes with blood eosiniphilia using Cox regression analysis.

Results: Among COPD patients, current use of ICS was not associated with a reduced risk of acute COPD exacerbations, COPD-related hospitalisations/accident and emergency visits, and all-cause mortality. Stratification of ICS use by absolute or relative eosinophil counts did not result in significant differences in risk of COPD exacerbations or hospitalisations/accident and emergency visits. However, all-cause mortality was reduced by 12% to 24% among patients with eosinophilia.

Conclusions: COPD-related acute exacerbations or hospitalisations/accident and emergency visits were not reduced with eosinophilia among users of ICS with COPD. However, all-cause mortality was reduced by 12% to 24%. These findings are potentially important and require further evaluation in prospective studies.

Keywords: chronic obstructive pulmonary disease; eosinophils; exacerbations; inhaled corticosteroids; pharmacoepidemiology.

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Figures

Figure 1
Figure 1
Flow chart showing the selection of eligible patients
Figure 2
Figure 2
Kaplan‐Meier curve showing (A) the proportion of patients without exacerbations with current ICS users stratified by blood eosinophil counts, (B) the proportion of patients without COPD hospitalisations/accident and emergency visits among current ICS users stratified by blood eosinophil counts, and (C) the proportion of patients who survived among current ICS users stratified by relative blood eosinophil counts [Colour figure can be viewed at http://wileyonlinelibrary.com]
See this image and copyright information in PMC

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References

    1. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med [Internet]. 2017;195(5):557‐582. Available from: doi: 10.1164/rccm.201701-0218PP - DOI - PubMed
    1. Calverley PMA, Anderson JA, Celli B, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med [internet]. 2007;356(8):775‐789. Available from: http://www.ncbi.nlm.nih.gov/26641631/17314337 - PubMed
    1. Wedzicha JA, Seemungal TA. COPD exacerbations: defining their cause and prevention. Lancet. 2007;370(9589):786‐796. - PMC - PubMed
    1. Kew KM, Seniukovich A. Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease. Cochrane Database Syst Rev [Internet]. 2014;3:CD010115 Available from: 10.1002/14651858.CD010115.pub2 - DOI - PMC - PubMed
    1. Vedel‐Krogh S, Nielsen SF, Lange P, Vestbo J, Nordestgaard BG. Blood eosinophils and exacerbations in COPD: the Copenhagen General Population Study. Am J Respir Crit Care Med [Internet]. 2015;rccm.201509‐1869OC. Available from: http://www.atsjournals.org/doi/10.1164/rccm.201509-1869OCn http://www.ncbi.nlm.nih.gov/26585525/26641631 - DOI - PubMed

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