Absolute Blood Eosinophil Counts to Guide Inhaled Corticosteroids Therapy Among Patients with COPD: Systematic Review and Meta-analysis

Current Drug Targets
Olorunfemi A OshagbemiIsmaeel Yunusa

Abstract

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 recommends the use of absolute blood eosinophil count as a guide for the escalation and de-escalation of inhaled corticosteroids (ICS) in the pharmacological management of patients with chronic obstructive pulmonary disease (COPD). We evaluated the risk of moderate or severe exacerbations among patients escalating and de-escalating ICS therapy by absolute blood eosinophil thresholds in this systematic review. Through a comprehensive literature search of Pubmed/MEDLINE, EMBASE, and clinical trial sites up to April 2019, we identified relevant studies. We used generic inverse variance method with fixed-effects estimates to compare the risk of moderate or severe exacerbations among COPD patients with elevated blood eosinophil counts exposed to inhaled corticosteroids (ICS) versus non-ICS treatments groups expressed as risk ratios. Ten studies (8 randomised control trials and 2 observational studies) were included, with a total of 85,059 COPD patients. In our pooled analysis, we found an overall reduction in risk of moderate or severe exacerbations in patients with absolute blood eosinophil thresholds ranging from ≥ 100 to ≥ 340 cells/µL among patients escalatin...Continue Reading

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Citations

Dec 10, 2019·The Clinical Respiratory Journal·Stanca-Patricia HogeaCristian Oancea
Sep 5, 2020·Expert Review of Clinical Pharmacology·Paola RoglianiLuigino Calzetta
Nov 3, 2020·Expert Opinion on Pharmacotherapy·Beatrice Ludovica RitondoPaola Rogliani
Jul 24, 2021·International Journal of Chronic Obstructive Pulmonary Disease·Kjell E J HåkanssonCharlotte Suppli Ulrik

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