Eosinophilic Chronic Obstructive Pulmonary Disease: Implications for Exacerbations, Readmissions, and Treatment

Eur Respir J (1) Reviewed by Mona T. Vashi Eosinophilia is a hallmark of asthma, but recent studies have shown eosinophilic inflammation in some patients with chronic obstructive pulmonary disease (COPD) (2). 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. Placebo as Add-On Treatment for Frequently Exacerbating COPD Patients Characterized by Eosinophil Level), were performed in patients with COPD with a history of two or more moderate or one or more severe exacerbations in the prior year and use of triple-inhaler therapy (high-dose corticosteroid, long-acting ß2-agonist, and long-acting muscarinic-receptor antagonist) in the prior 3 months. In that same figure, the authors included a post hoc analysis of patients from both studies with historic eosinophilia without eosinophilia at screening, which demonstrated an even greater treatment effect for mepolizumab than those with screening eosinophilia of 500/ml or greater.