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2017 ; 12
(ä): 1819-1824
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Relationship between blood eosinophils, clinical characteristics, and mortality
in patients with COPD
#MMPMID28694695
Zysman M
; Deslee G
; Caillaud D
; Chanez P
; Escamilla R
; Court-Fortune I
; Nesme-Meyer P
; Perez T
; Paillasseur JL
; Pinet C
; Jebrak G
; Roche N
; Burgel PR
Int J Chron Obstruct Pulmon Dis
2017[]; 12
(ä): 1819-1824
PMID28694695
show ga
In patients with COPD, there is controversy regarding the association of blood
eosinophil (Eos) levels with 1) exacerbation frequency and 2) the effect of
inhaled corticosteroids for prevention of exacerbations. To determine whether Eos
define subgroups of patients exhibiting attributes of COPD clinical phenotypes,
we compared clinical features and mortality rates in COPD patients from the
Initiatives BPCO French cohort categorized using different thresholds of blood
Eos levels. The following data were collected at inclusion: medical and smoking
history, occupational exposures, dyspnea, cough and sputum production,
exacerbations in the previous year, history of allergy and asthma, nasal
symptoms, body mass index, St George Respiratory Questionnaire (SGRQ) total
score, post-bronchodilator spirometry, comorbidities, and medications. Three-year
survival between groups was compared using Kaplan-Meier analysis. Three sets of
analyses were performed to compare patients with ?2% versus <2%, ?3% versus <3%,
and ?4% versus <4% Eos. Eos was available in 458 patients (mean age: 62 years,
72% male, mean forced expiratory volume in 1 second: 51% pred), including 235
patients with Eos ?2% (49%), 149 with Eos ?3% (33%), and 90 with Eos ?4% (20%).
For all cutoffs, there was no difference between Eos+ and Eos- groups in
univariate analyses except for diabetes and SGRQ score (more frequent and more
impaired, respectively, in lower Eos categories). In particular, there was no
difference in exacerbation rate, history of asthma, or three-year survival. In
conclusion, regardless of the cutoff, Eos+ COPD patients exhibited no specific
characteristic in terms of symptoms, lung function, exacerbation rate, and
prognosis. These findings suggest that the association of higher Eos with
exacerbations reported in previous studies could be population specific, which
does not support generalizing the use of Eos as a biomarker for COPD phenotyping.