Abstract
Background: A step up from LAMA/LABA dual therapy to ICS/LAMA/LABA triple therapy is recommended in patients with ongoing COPD exacerbations and a blood eosinophil count (EOS) ≥100 cells/mm3. EOS may fluctuate over time.
Aim: To determine EOS cut-offs for initiating triple therapy.
Methods: ETHOS (NCT02465567) was a randomized 52-week study in patients with ≥1 moderate/severe COPD exacerbation in the past year; EOS was measured at baseline and at several other visits. Maximum-, minimum- and median-based methods to evaluate EOS were compared to a baseline measure for predicting ICS response, as assessed by exacerbation rates in the budesonide/glycopyrronium/formoterol fumarate dihydrate 320/14.4/10 µg BID and glycopyrronium/formoterol fumarate dihydrate 14.4/10 µg BID study arms.
Results: Baseline EOS (Figure A), maximum EOS (Figure B) and median EOS (Figure C) were discriminatory for predicting ICS response; minimum EOS provided lesser utility in identifying ICS responders (Figure D). Maximum EOS suggests that a single high value (>250 cells/mm3) identifies ICS responders.
Conclusions: Baseline EOS, maximum EOS and median EOS were able to predict ICS responders. Maximum EOS may provide an additional method to identify patients who may benefit from ICS, although this is not necessarily of greater value than using the baseline EOS measure.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 4346.
This article was presented at the 2022 ERS International Congress, in session “-”.
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 2022
