RT Journal Article SR Electronic T1 Evaluating multiple eosinophil measurements when stepping up to ICS/LAMA/LABA triple therapy in patients with COPD: a post-hoc analysis of ETHOS JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 4346 DO 10.1183/13993003.congress-2022.4346 VO 60 IS suppl 66 A1 D Singh A1 M Bafadhel A1 J R Hurst A1 P Darken A1 M Patel YR 2022 UL http://erj.ersjournals.com/content/60/suppl_66/4346.abstract AB 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. FootnotesCite 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).