Pneumologie 2017; 71(S 01): S1-S125
DOI: 10.1055/s-0037-1598316
Posterbegehung – Sektion Klinische Pneumologie
COPD I – Andreas Rembert Koczulla/Marburg, Henrik Watz/Großhansdorf
Georg Thieme Verlag KG Stuttgart · New York

Screennig eosinophil counts and risk of exacerbations after inhaled corticosteroid withdrawal in severe COPD

PMA Calverley
1  Institute of Ageing and Chronic Disease, Aintree University Hospital
,
EFM Wouters
2  Department of Respiratory Medicine, Maastricht University Medical Center
,
H Finngan
3  Department of Biostatistics and Data Sciences, Boehringer Ingelheim
,
K Tetzlaff
4  Boehringer Ingelheim Pharma GmbH & Co. Kg, Ingelheim; Department of Sports Medicine, University of Tübingen
,
H Magnussen
5  Pulmonary Research Institute at Lung Clinic Großhansdorf, Airway Research Center North, German Center for Lung Research
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
23. Februar 2017 (online)

 

Introduction:

Blood eosinophil counts may predict response to inhaled corticosteroids (ICS) in patients with COPD with a history of exacerbations.

Aim:

To investigate if higher screening blood eosinophil counts were associated with more exacerbations after ICS withdrawal in the WISDOM study.

Methods:

In WISDOM (NCT00975195; 12-month, randomised, parallel-group study), patients with severe to very severe COPD and a history of exacerbations received 18 µg tiotropium, 100 µg salmeterol and 1000 µg fluticasone propionate daily for 6 weeks then continued or reduced ICS over the next 12 weeks. This post hoc analysis after complete ICS withdrawal compared exacerbation outcomes based on analysis of mutually exclusive blood eosinophil subgroups.

Results:

2296 patients were followed post-ICS withdrawal. Moderate or severe exacerbation rate ratios were similar in patients with eosinophil counts < 2%, ≥2-< 3%, ≥3-< 4%, < 150 cells/µL or 150-< 300 cells/µL (Figure). Exacerbation rate increased in the ICS-withdrawal versus the ICS arm for blood eosinophil subgroups ≥4-< 5%, ≥5-< 6%, ≥6%, ≥300-< 400 cells/µL and ≥400 cells/µL, reaching statistical significance in the ≥5-< 6% and ≥400 cells/µL subgroups.

Conclusions:

In WISDOM, high screening blood eosinophil count (≥4% or ≥300 cells/µL) predicted an increased exacerbation risk in patients with severe to very severe COPD after ICS withdrawal.

Funding:

Boehringer Ingelheim

Zoom Image
Fig. 1

Content already presented at ERS congress 2016