Blood eosinophilia, use of inhaled corticosteroids, and risk of COPD exacerbations and mortality.
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Date
2018-11
Publication Type
Journal Article
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no
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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.
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Publication status
published
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Book title
Journal / series
Volume
27 (11)
Pages / Article No.
1191 - 1199
Publisher
Wiley
Event
Edition / version
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Software
Geographic location
Date collected
Date created
Subject
COPD; Eosinophilia; Chronic obstructive pulmonary disease; Exacerbations; Inhaled corticosteroids; Pharmacoepidemiology; COPD; Eosinophilia
Organisational unit
09633 - Burden, Andrea (ehemalig) / Burden, Andrea (former)