Effect of inhaled corticosteroids on blood eosinophil count in steroid-naïve patients with COPD

James L Kreindler, Michael L Watkins, Sally Lettis, Ruth Tal-Singer, Nicholas Locantore, James L Kreindler, Michael L Watkins, Sally Lettis, Ruth Tal-Singer, Nicholas Locantore

Abstract

Introduction: Sputum and blood eosinophil counts have attracted attention as potential biomarkers in chronic obstructive pulmonary disease (COPD). One question regarding the use of blood eosinophils as a biomarker in COPD is whether their levels are affected by the use of inhaled corticosteroids (ICS), which are commonly prescribed for COPD.

Methods: We performed a retrospective analysis of peripheral blood leucocytes from a previously completed clinical trial that examined effects of ICS in steroid-naïve patients with COPD.

Results and conclusion: The data show that the ICS-containing treatment arms (containing fluticasone propionate) had a small effect on peripheral blood eosinophils in steroid-naïve patients with COPD.

Trial registration number: NCT00358358; Post-results.

Keywords: COPD Pharmacology; Eosinophil Biology.

Figures

Figure 1
Figure 1
Empirical distribution function for SCO104925 patients and the ECLIPSE cohorts.
Figure 2
Figure 2
Peripheral blood eosinophil levels based on a threshold of (A) 150 cells/μL, patients not randomised to inhaled corticosteroids (ICS)-containing treatment (n=59), (B) 150 cells/μL, patients randomised to ICS-containing treatment (n=53), (C) 300 cells/μL, patients not randomised to ICS-containing treatment (n=59) and (D) 300 cells/μL, patients randomised to ICS-containing treatment (n=53).

References

    1. Brightling CE, McKenna S, Hargadon B et al. . Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease. Thorax 2005;60:193–8.
    1. Ortega HG, Liu MC, Pavord ID et al. . Mepolizumab treatment in subjects with severe eosinophilic asthma. N Engl J Med 2014;371:1198–207.
    1. Bafadhel M, McKenna S, Terry S et al. . Blood eosinophils to direct corticosteroid treatment of exacerbations of chronic obstructive pulmonary disease: a randomized placebo-controlled trial. Am J Respir Crit Care Med 2012;186:48–55.
    1. Pascoe S, Locantore N, Dransfield MT et al. . Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials. Lancet Respir Med 2015;3:435–42.
    1. Siddiqui SH, Guasconi A, Vestbo J et al. . Blood eosinophils: a biomarker of response to extrafine beclomethasone/formoterol in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015;192:523–5.
    1. Vestbo J, Anderson W, Coxson HO et al. . Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE). Eur Respir J 2008;31:869–73.
    1. Hodges JR, Lehmann EL. Estimates of location based on rank tests. Ann Math Stat 1963;34:598–611.
    1. Summary: CTR Summary for MDC—GSK Clinical Study Register. (accessed 1 Aug 2016).
    1. Pizzichini E, Pizzichini MM, Gibson P et al. . Sputum eosinophilia predicts benefit from prednisone in smokers with chronic obstructive bronchitis. Am J Respir Crit Care Med 1998;158(Pt 1):1511–17.
    1. Siva R, Green RH, Brightling CE et al. . Eosinophilic airway inflammation and exacerbations of COPD: a randomised controlled trial. Eur Respir J 2007;29:906–13.
    1. Liesker JJ, Bathoorn E, Postma DS et al. . Sputum inflammation predicts exacerbations after cessation of inhaled corticosteroids in COPD. Respir Med 2011;105:1853–60.
    1. Keatings VM, Jatakanon A, Worsdell YM et al. . Effects of inhaled and oral glucocorticoids on inflammatory indices in asthma and COPD. Am J Respir Crit Care Med 1997;155:542–8.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する