TY - JOUR T1 - Late Breaking Abstract - Blood eosinophil counts and treatment response in COPD: analyses of IMPACT JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2018.OA2127 VL - 52 IS - suppl 62 SP - OA2127 AU - Steven Pascoe AU - Neil Barnes AU - Guy Brusselle AU - Chris Compton AU - Gerard Criner AU - Mark Dransfield AU - David M.G. Halpin AU - Meilan K. Han AU - Benjamin Hartley AU - Emma Hilton AU - Peter Lange AU - Sally Lettis AU - David A. Lipson AU - David Lomas AU - Fernando J. Martinez AU - Alberto Papi AU - Nicolas Roche AU - Ralf J.P. Van Der Valk AU - Robert Wise AU - Dave Singh Y1 - 2018/09/15 UR - http://erj.ersjournals.com/content/52/suppl_62/OA2127.abstract N2 - Background: IMPACT is a landmark >10,000 patient study that simplifies patient care in COPD and prospectively identifies phenotypes/endotypes associated with preferential response to inhaled maintenance treatments. Previous studies have shown a relation between ICS-associated reduction in the rate of acute exacerbation of COPD (AECOPD) and baseline blood eosinophil count (BEC).Methods: IMPACT is a randomised, double-blind, parallel-group, 52-week, global study comparing once-daily fluticasone furoate(FF)/umeclidinium(UMEC)/vilanterol(VI) to components FF/VI and UMEC/VI. Eligible patients had moderate to severe COPD and experienced ≥1 moderate/severe AECOPD in the past 12 months. We used negative binomial regression with fractional polynomials for modelling of continuous BEC, to model the number of moderate/severe AECOPD, comparing subjects in the 3 treatment groups.Results: The magnitude of benefit of ICS containing arms (FF/UMEC/VI [N=4,151] and FF/VI [N=4,134]) compared to non-ICS (UMEC/VI [N=2,070]) in reducing the rate of moderate/severe AECOPD increased in proportion to BEC (Fig 1).Conclusions: In exacerbating COPD patients treated with UMEC/VI but not in those receiving FF (ICS), exacerbation rate increases with increasing BEC. Baseline BEC is linked with FF-associated exacerbation reduction on a continuous scale. This analysis prospectively confirms the value of BEC in the management of COPD. FootnotesCite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA2127.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). ER -