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Is there an endotype to the treatable eosinophilic trait of chronic obstructive pulmonary disease (COPD)

Olivia Walsh, Manoj Marathe, Harmesh Moudgil, Koottalai Srinivasan, Emma Crawford, Annabel Makan, Nawaid Ahmad
European Respiratory Journal 2021 58: PA3425; DOI: 10.1183/13993003.congress-2021.PA3425
Olivia Walsh
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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  • For correspondence: oliviawalsh@doctors.org.uk
Manoj Marathe
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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Harmesh Moudgil
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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Koottalai Srinivasan
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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Emma Crawford
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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Annabel Makan
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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Nawaid Ahmad
1Shrewsbury and Telford NHS trust, Shropshire, United Kingdom
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Abstract

Introduction: There has been much interest in defining phenotypes in COPD particularly in relation to eosinophils and whether it is a treatable trait. Augusti el al (1) have suggested defining an endotype of COPD and moving away from clinical measures, when it comes to offering treatment. An endotype in eosinophilic COPD remains to be explored. Our main aim was to define an endotype for the treatable eosinophilic trait of COPD particularly focusing on the Body Mass Index (BMI), as previous reports have shown this trait may have a BMI≥25 kg/m2(2).

Methods and Aims: A retrospective analysis was done reviewing the results of all COPD patients with an FEV1: FVC ratio <0.7, discussed at the local Multi-disciplinary Team meeting in 2019 and 2020. We excluded patients with Asthma and Overlap syndrome. Serum eosinophil levels over the past 3 years and BMI were obtained from the local electronic portal and MDT pro forma. We compared highest 3 year eosinophil counts (EC) in those with BMI < and ≥25 kg/m2. We used MS Excel and Vassar stats for statistical calculations.

Results: 168 patients were reviewed of which 24 patients were excluded based on the inclusion criteria, leaving 144 patients for analysis. The mean age (SD) was 57 (6.8) years. 58% (n= 84) were males. 39% (n=56) patients had BMI<25 kg/m2 (Group A) and 61% (n=88) patients had BMI≥25 kg/m2 (Group B). Mean (SD) of EC was 0.16x109/L (0.08) in Group A v Mean (SD) of EC 0.34 x109/L (0.14) in Group B [95% CI 0.14-0.21; p < 0.0001].

Our data show that patients with a BMI≥25 kg/m2 is an endotype of COPD patients who have EC>0.2 x109/L. Further research into this endotype and targeted treatments for eosinophilic COPD needs to be carried out.

  • Airway management
  • COPD - management
  • COPD

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3425.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Is there an endotype to the treatable eosinophilic trait of chronic obstructive pulmonary disease (COPD)
Olivia Walsh, Manoj Marathe, Harmesh Moudgil, Koottalai Srinivasan, Emma Crawford, Annabel Makan, Nawaid Ahmad
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3425; DOI: 10.1183/13993003.congress-2021.PA3425

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Is there an endotype to the treatable eosinophilic trait of chronic obstructive pulmonary disease (COPD)
Olivia Walsh, Manoj Marathe, Harmesh Moudgil, Koottalai Srinivasan, Emma Crawford, Annabel Makan, Nawaid Ahmad
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3425; DOI: 10.1183/13993003.congress-2021.PA3425
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