COPD

Exacerbation Risk Predictors Identified for COPD Patients

Blood eosinophil count is predictive of exacerbation risk and response to inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) being treated with formoterol, a new study showed.

For their study, the researchers evaluated data on 4528 COPD patients enrolled in 3 trials of budesonide-formoterol. All patients included in the study had a history of exacerbations and available blood eosinophil counts.
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The primary outcome was assessed via negative binomial regression analysis, with splines used to model continuous variables.

Results indicated that a non-linear increase in exacerbation occurred with increasing eosinophil counts in patients treated with formoterol alone. The researchers observed a significant treatment effect for exacerbation reduction with budesonide-formoterol vs formoterol alone at eosinophil counts of 0.10 × 109 cells per L or more (rate ratio 0.75).

The St George's Respiratory Questionnaire and pre-bronchodilator FEV1 revealed interactions between eosinophil count and the treatment effects of budesonide-formoterol over formoterol. Response to budesonide-formoterol in reducing exacerbations was found to be independently predicted by eosinophil count and smoking history.

“In patients with COPD treated with formoterol, blood eosinophil count predicts exacerbation risk and the clinical response to ICS,” the researchers concluded.

—Christina Vogt

Reference:

Bafadhel M, Peterson S, De Blas MA, et al. Predictors of exacerbation risk and response to budesonide in patients with chronic obstructive pulmonary disease: a post-hoc analysis of three randomised trials [Published online January 10, 2018]. The Lancet Respir Med. http://dx.doi.org/10.1016/S2213-2600(18)30006-7.