Extract
Blood eosinophil count is a readily available biomarker in COPD that can assist identification of patients most likely to benefit from inhaled corticosteroids (ICS) [1]. Recent evidence has demonstrated a link between blood eosinophil count as a continuous variable and magnitude of response to ICS in terms of exacerbation rate reduction [2, 3]. The current Global Initiative for Chronic Obstructive Lung Disease (GOLD) report recommends that blood eosinophil count can be used to predict the likelihood of beneficial response to ICS, in combination with clinical assessment of exacerbation risk [1]. However, as blood eosinophil counts can show variability, particularly at higher levels [4–6], it is of clinical interest to determine how many measurements are sufficient to predict an ICS response in patients with COPD. Data from the InforMing the PAthway of COPD Treatment (IMPACT) trial showed an association between blood eosinophil count and ICS response on reduction of moderate/severe COPD exacerbations [3]. This post hoc analysis of IMPACT compared whether one or two measurements of blood eosinophil count can better predict ICS responses in patients with COPD.
Abstract
This post hoc analysis of the IMPACT trial demonstrated that a single blood eosinophil count measurement is sufficient to predict a beneficial response to inhaled corticosteroids in patients with symptomatic COPD and a history of exacerbations https://bit.ly/3wgeDCU
Acknowledgements
Editorial support (in the form of writing assistance, assembling figures, collating author comments, grammatical editing and referencing) was provided by Eloise Morecroft and Katie Baker, at Fishawack Indicia Ltd, UK, and was funded by GSK. D. Singh is supported by the National Institute for Health Research (NIHR) Manchester Biomedical Research Centre (BRC). D.A. Lomas is supported by the National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre (BRC) and is an NIHR Senior Investigator.
Footnotes
This study is registered at Clinicaltrials.gov with identifier number NCT02164513. Anonymised individual participant data and study documents can be requested for further research from www.clinicalstudydatarequest.com
Author contributions: M. Bafadhel, N. Barnes, S.C. Bourke, C. Compton, B. Hartley, S. Lettis, D.A. Lipson, N. Martin and D. Singh contributed to the conception/design of this analysis. G.J. Criner, M.T. Dransfield and D.M.G. Halpin were also involved in acquisition of data, and all authors were involved in analysis and interpretation of the data and editing of the article and approved the final version of the manuscript before submission.
Conflict of interest: M. Bafadhel reports grants from AstraZeneca; advisory board attendance for AstraZeneca, Chiesi, Boehringer Ingelheim and GSK (in the last 3 years); attendance at educational meetings facilitated by AstraZeneca, Chiesi and Boehringer Ingelheim (in the last 3 years); and scientific advisor for ProAxsis and AlbusHealth.
Conflict of interest: N. Barnes is an employee of GSK and holds stocks and shares in GSK.
Conflict of interest: S.C. Bourke reports research grants from GSK, Philips, ResMed and Pfizer Open Air, support to attend scientific meetings from Boehringer Ingelheim, Chiesi, GSK and AstraZeneca and personal fees from Novartis, Chiesi and ResMed.
Conflict of interest: C. Compton is an employee of GSK and holds stocks and shares in GSK.
Conflict of interest: G.J. Criner reports personal fees from Almirall, Amgen, AstraZeneca, Boehringer Ingelheim, Broncus Medical, Chiesi, CSA Medical, Eolo, Gala Therapeutics, GSK, Helios Medical, Medtronic, Merck, Mereo BioPharma, NGM Pharmaceuticals, Novartis, Nuvaira, Olympus, Philips Respironics, Pulmonx, Respivant Sciences, The Implementation Group and Verona; and has ownership interest in HGE Technologies.
Conflict of interest: M.T. Dransfield reports personal fees from AstraZeneca, Boehringer Ingelheim, PneumRx/BTG, Quark Pharmaceuticals and GSK, grant support from the American Lung Association, Department of Defense, Department of Veterans Affairs and NIH, and contracted clinical trial support from Boehringer Ingelheim, Novartis, AstraZeneca, Yungjin, PneumRx/BTG, Pulmonx, Boston Scientific, Gala, Nuvaira and GSK.
Conflict of interest: D.M.G. Halpin reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis, Pfizer and Sanofi, and non-financial support from Boehringer Ingelheim and Novartis.
Conflict of interest: M.K. Han reports personal fees from AstraZeneca, GSK, Mylan, Merck and Boehringer Ingelheim, and research support from Novartis and Sunovion.
Conflict of interest: B. Hartley is a contingent worker with a contract research organisation working on behalf of GSK and holds shares in GSK.
Conflict of interest: C.E. Jones is an employee of GSK and holds stocks and shares in GSK.
Conflict of interest: P. Lange reports personal fees from GSK, AstraZeneca and Boehringer Ingelheim, and grant support from Boehringer Ingelheim and GSK.
Conflict of interest: S. Lettis is an employee of GSK and holds stocks and shares in GSK.
Conflict of interest: D.A. Lipson is an employee of GSK and holds stocks and shares in GSK.
Conflict of interest: D.A. Lomas reports grant income, honoraria, and consultancy fees from GSK, and personal fees from Grifols, and chaired the GSK Respiratory Therapy Area Board 2012–2015.
Conflict of interest: N. Martin is an employee of GSK and holds stocks and shares in GSK.
Conflict of interest: F.J. Martinez reports personal fees and non-financial support from the American College of Chest Physicians, AstraZeneca, Boehringer Ingelheim, Continuing Education, ConCert, Genentech, GSK, Inova Fairfax Health System, Miller Communications, National Society for Continuing Education, Novartis, Pearl Pharmaceuticals, PeerView Communications, Prime Communications, Puerto Rico Respiratory Society, Chiesi, Roche, Sunovion, Theravance, Potomac, University of Alabama Birmingham, Physicians Education Resource, Canadian Respiratory Network and Teva, non-financial support from ProterrixBio, Gilead, Nitto and Zambon, and personal fees from Columbia University, Integritas, MD Magazine, Methodist Hospital Brooklyn, New York University, Unity, UpToDate, WedMD/MedScape, Western Connecticut Health Network, Academic CME, Patara, PlatformIQ, American Thoracic Society, Rockpointe and France Foundation, grant support from NIH, Rare Disease Health Communications and ProMedior, and is a member of steering committees for Afferent/Merck, Biogen, Veracyte, Prometic, Bayer and Bridge Biotherapeutics.
Conflict of interest: R. Wise reports personal fees from AstraZeneca/MedImmune, Boehringer Ingelheim, ContraFect, Pulmonx, Roche, Spiration, Sunovion, Merck, Circassia, Pneuma, Verona, Bonti, Denali, Aradigm, Mylan/Theravance, Propeller Health, AbbVie and GSK, and grant support from AstraZeneca/MedImmune, Boehringer Ingelheim, Pearl Therapeutics, GSK and Sanofi-Aventis.
Conflict of interest: D. Singh reports personal fees from GSK, AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Genentech, Glenmark, Menarini, Mundipharma, Novartis, Peptinnovate, Pfizer, Pulmatrix, Theravance and Verona, and grant support from AstraZeneca, Boehringer Ingelheim, Chiesi, Glenmark, Menarini, Mundipharma, Novartis, Pfizer, Pulmatrix, Theravance and Verona.
Support statement: This study was funded by GlaxoSmithKline (GSK; CTT116855; Clinicaltrials.gov identifier: NCT02164513). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received December 22, 2020.
- Accepted May 12, 2021.
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