Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses

Clinical Drug Investigation
Ahmar IqbalJean Brooks

Abstract

Chronic obstructive pulmonary disease (COPD) patients with blood eosinophil (EOS) count ≥ 2% benefit from exacerbation reductions with inhaled corticosteroids (ICSs). We conducted post hoc analyses to determine if EOS count ≥ 2% is a marker for greater responsiveness to the bronchodilators umeclidinium (UMEC; long-acting muscarinic antagonist), vilanterol (VI; long-acting β2-agonist) or UMEC/VI combination. Effects of once-daily UMEC/VI 62.5/25, UMEC 62.5 and VI 25 µg versus placebo on trough forced expiratory volume in one second (FEV1), Transition Dyspnoea Index (TDI), St George's Respiratory Questionnaire (SGRQ) scores and adverse event (AE) incidences in four completed, 6-month studies were assessed by EOS subgroup. Trough FEV1 was also evaluated by ICS use and EOS subgroup. Analyses were performed using a repeated measures model. At baseline, 2437 of 4647 (52%) patients had EOS count ≥ 2%. Overall, ≈ 50% of patients used ICSs. At day 169, no notable variations were observed in trough FEV1 least squares mean differences between EOS subgroups versus placebo for UMEC/VI, UMEC and VI; results according to ICS use were similar. No differences were reported between EOS subgroups in TDI and SGRQ scores on day 168, or for incidenc...Continue Reading

References

Jun 18, 2011·American Journal of Respiratory and Critical Care Medicine·Mona BafadhelChristopher E Brightling
Mar 27, 2012·American Journal of Respiratory and Critical Care Medicine·Mona BafadhelChristopher E Brightling
May 23, 2012·Pharmacological Reviews·Mario CazzolaM Gabriella Matera
Dec 12, 2012·Mediators of Inflammation·George Karakiulakis, Michael Roth
Jul 9, 2013·Respiratory Medicine·J F DonohueA Church
Jun 9, 2015·American Journal of Respiratory and Critical Care Medicine·Salman H SiddiquiDave Singh

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Citations

Aug 2, 2016·Journal of Primary Health Care·Linda Bryant
Mar 27, 2018·Expert Review of Respiratory Medicine·Job J M H van BragtAnke H Maitland-van der Zee
Jul 2, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Alberto BraghiroliNicola Scichilone
Jul 1, 2020·Terapevticheskiĭ arkhiv·S N AvdeevE V Kusraeva

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NCT01313637
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