以下用吸入糖皮质激素可预测COPD JF欧洲呼吸杂志JO欧洲呼吸ĴFD欧洲呼吸协会SP长期的临床反应1902119 DO 10.1183 / 13993003.02119-2019 VO 55 5个A1 Mathioudakis治疗RT期刊论文SR电子T1变化血嗜酸粒细胞188bet官网地址亚历山大G. A1 Bikov，安德拉斯A1福登，菲利普A1 Lahousse，谎言A1 Brusselle，盖伊A1辛格，大卫A1 Vestbo，耶尔YR 2020 UL //www.qdcxjkg.com/content/55/5/1902119.abstractAB有血嗜酸性粒细胞计数（EOS）作为生物标志物来指导吸入糖皮质激素（ICS）治疗慢性阻塞性肺病的新兴角色。Since ICS administration could influence EOS, we hypothesised that change in EOS following treatment with ICS may predict outcomes of long-term therapy.In a post hoc analysis of ISOLDE, a 3-year, double-blind trial comparing 500 µg fluticasone propionate twice daily with placebo in 751 patients with moderate-to-severe COPD, we evaluated whether the initial changes in EOS during ICS treatment were predictive of ICS treatment response.EOS change within 1 year after the introduction of ICS was strongly predictive of treatment response. A suppressed EOS was associated with treatment effect. Characteristically, in patients with EOS suppression of ≥200 cells·μL−1, ICS use was associated with a decelerated rate of decline of forced expiratory volume in 1 s (FEV1), by 32 mL·year−1, and a 30% reduction in the exacerbation rate. In contrast, in patients experiencing an increase in EOS of ≥200 cells·μL−1, ICS use was associated with an accelerated rate of decline of FEV1, by 37 mL·year−1 and an 80% increase in the exacerbation rate (p<0.0001). EOS change was not predictive of clinical response with regards to health status evaluated using the St George's Respiratory Questionnaire.These findings suggest that EOS change after ICS administration may predict clinical response to ICS therapy in patients with moderate-to-severe COPD at risk of exacerbations. ICS administration may be associated with more frequent exacerbations and an accelerated lung function decline in the 20% of patients in whom EOS increases after the administration of ICS. These hypothesis-generating observations will need validation in prospectively designed studies.The ISOLDE trial was conducted before the ICJME recommended a prospective registration of RCT protocols.Blood eosinophil change in response to ICS may predict long-term response to ICS in COPD. A rise in eosinophils was observed in 20% of participants in ISOLDE and was associated with lack of clinical benefit and a potential risk of harm. http://bit.ly/3bPKLnD