scholarly journals P7‐47: Blood eosinophil count as a predictive biomarker of COPD exacerbation in a real‐world setting

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 276-277
Keyword(s):  
Real World ◽  
Eosinophil Count ◽  
Predictive Biomarker ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Blood Eosinophil Count ◽  
Real World Setting

scholarly journals The association between eosinophilic exacerbation and eosinophilic levels in stable COPD

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hye Seon Kang ◽  
Sung Kyoung Kim ◽  
Yong Hyun Kim ◽  
Jin Woo Kim ◽  
Sang Haak Lee ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Acute Exacerbations ◽  
Retrospective Multicenter Study ◽  
Predict Treatment Response ◽  
Eosinophil Counts

Abstract Background Blood eosinophil count may predict treatment response in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbations (AE). However, the ability and thresholds of blood eosinophil counts in stable status to predict eosinophilic AECOPD have not been completely investigated. Methods This was a retrospective multicenter study performed January 2010 to December 2014. COPD subjects hospitalized with exacerbations, were included. Blood samples were obtained at the time of AE and stable disease at outpatient clinic before or after admission. We identified a blood eosinophil count cut-off point at stable COPD, either taken as a percentage or as absolute value, for identification of eosinophilic exacerbation. Results There was significant positive correlation of eosinophil counts between stable COPD and AECOPD. The best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation based on blood eosinophil count ≥ 2% was 300 cells/µL (area under the ROC curve [AUC] 0.614, P = 0.001, 39% sensitivity, 83.8% specificity). When the eosinophilic COPD exacerbation was based on blood eosinophil count ≥ 300 cells/µL, the best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation was also 300 cells/uL (AUC 0.634, P = 0.046, 45.8% sensitivity, 80.9% specificity). Conclusions We demonstrated association between blood eosinophil counts at stable COPD and those with AECOPD. The thresholds of blood counts at stable COPD to predict eosinophilic exacerbations was 300 cells/µL. Further and prospective studies in other populations should validate our results.

scholarly journals The prediction of eosinophilic exacerbation by eosinophil levels stratified in stable COPD

2020 ◽  
Author(s):  
Hye Seon Kang ◽  
Sung Kyoung Kim ◽  
Yong Hyun Kim ◽  
Jin Woo Kim ◽  
Sang Haak Lee ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Acute Exacerbations ◽  
Retrospective Multicenter Study ◽  
Predict Treatment Response ◽  
Eosinophil Counts

Abstract Background Blood eosinophil count may predict treatment response in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbations (AE). However, the ability and thresholds of blood eosinophil counts in stable status to predict eosinophilic AECOPD have not been completely investigated. Methods This was a retrospective multicenter study performed January 2010 to December 2014. COPD subjects hospitalized with exacerbations, were included. Blood samples were obtained at the time of AE and stable disease at outpatient clinic before or after admission. We identified a blood eosinophil count cut-off point at stable COPD, either taken as a percentage or as absolute value, for identification of predicting blood eosinophil count at AECOPD. Results There was significant positive correlation of eosinophil counts between stable COPD and AECOPD. The best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation based on blood eosinophil count ≥ 2% was 300 cells/µL (area under the ROC curve [AUC] 0.614, P = 0.001, 39% sensitivity, 83.8% specificity). When the eosinophilic COPD exacerbation was based on blood eosinophil count ≥ 300 cells/µL, the best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation was also 300 cells/uL (AUC 0.634, P = 0.046, 45.8% sensitivity, 80.9% specificity). Conclusions We demonstrated association between blood eosinophil counts at stable COPD and those with AECOPD. The thresholds of blood counts at stable COPD to predict eosinophilic exacerbations was 300 cells/µL. Further and prospective studies in other populations should validate our results.

scholarly journals Treatment failure and hospital readmissions in severe COPD exacerbations treated with azithromycin versus placebo – a post-hoc analysis of the BACE randomized controlled trial

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Kristina Vermeersch ◽  
◽  
Ann Belmans ◽  
Kris Bogaerts ◽  
Iwein Gyselinck ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Incidence Rate ◽  
Eosinophil Count ◽  
Hospital Readmissions ◽  
Smoking History ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Blood Eosinophil Count ◽  
Post Hoc Analysis ◽  
Post Hoc

Abstract Background In the BACE trial, a 3-month (3 m) intervention with azithromycin, initiated at the onset of an infectious COPD exacerbation requiring hospitalization, decreased the rate of a first treatment failure (TF); the composite of treatment intensification (TI), step-up in hospital care (SH) and mortality. Objectives (1) To investigate the intervention’s effect on recurrent events, and (2) to identify clinical subgroups most likely to benefit, determined from the incidence rate of TF and hospital readmissions. Methods Enrolment criteria included the diagnosis of COPD, a smoking history of ≥10 pack-years and ≥ 1 exacerbation in the previous year. Rate ratio (RR) calculations, subgroup analyses and modelling of continuous variables using splines were based on a Poisson regression model, adjusted for exposure time. Results Azithromycin significantly reduced TF by 24% within 3 m (RR = 0.76, 95%CI:0.59;0.97, p = 0.031) through a 50% reduction in SH (RR = 0.50, 95%CI:0.30;0.81, p = 0.006), which comprised of a 53% reduction in hospital readmissions (RR = 0.47, 95%CI:0.27;0.80; p = 0.007). A significant interaction between the intervention, CRP and blood eosinophil count at hospital admission was found, with azithromycin significantly reducing hospital readmissions in patients with high CRP (> 50 mg/L, RR = 0.18, 95%CI:0.05;0.60, p = 0.005), or low blood eosinophil count (<300cells/μL, RR = 0.33, 95%CI:0.17;0.64, p = 0.001). No differences were observed in treatment response by age, FEV1, CRP or blood eosinophil count in continuous analyses. Conclusions This post-hoc analysis of the BACE trial shows that azithromycin initiated at the onset of an infectious COPD exacerbation requiring hospitalization reduces the incidence rate of TF within 3 m by preventing hospital readmissions. In patients with high CRP or low blood eosinophil count at admission this treatment effect was more pronounced, suggesting a potential role for these biomarkers in guiding azithromycin therapy. Trial registration ClinicalTrials.gov number. NCT02135354.

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