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Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses
BACKGROUND: 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 bronchodilato...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579251/ https://www.ncbi.nlm.nih.gov/pubmed/26329916 http://dx.doi.org/10.1007/s40261-015-0322-6 |
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author | Iqbal, Ahmar Barnes, Neil C. Brooks, Jean |
author_facet | Iqbal, Ahmar Barnes, Neil C. Brooks, Jean |
author_sort | Iqbal, Ahmar |
collection | PubMed |
description | BACKGROUND: 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 β(2)-agonist) or UMEC/VI combination. METHODS: 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 (FEV(1)), 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 FEV(1) was also evaluated by ICS use and EOS subgroup. Analyses were performed using a repeated measures model. RESULTS: 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 FEV(1) 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 incidences of AEs, serious AEs and AEs leading to withdrawal. CONCLUSIONS: Response to UMEC/VI, UMEC and VI in terms of trough FEV(1), dyspnoea and health-related quality of life was similar for COPD patients with baseline EOS counts ≥2 or <2 %. EOS count did not appear to predict bronchodilator response in either ICS users or non-users. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40261-015-0322-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4579251 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-45792512015-09-25 Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses Iqbal, Ahmar Barnes, Neil C. Brooks, Jean Clin Drug Investig Short Communication BACKGROUND: 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 β(2)-agonist) or UMEC/VI combination. METHODS: 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 (FEV(1)), 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 FEV(1) was also evaluated by ICS use and EOS subgroup. Analyses were performed using a repeated measures model. RESULTS: 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 FEV(1) 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 incidences of AEs, serious AEs and AEs leading to withdrawal. CONCLUSIONS: Response to UMEC/VI, UMEC and VI in terms of trough FEV(1), dyspnoea and health-related quality of life was similar for COPD patients with baseline EOS counts ≥2 or <2 %. EOS count did not appear to predict bronchodilator response in either ICS users or non-users. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40261-015-0322-6) contains supplementary material, which is available to authorized users. Springer International Publishing 2015-09-02 2015 /pmc/articles/PMC4579251/ /pubmed/26329916 http://dx.doi.org/10.1007/s40261-015-0322-6 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Short Communication Iqbal, Ahmar Barnes, Neil C. Brooks, Jean Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses |
title | Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses |
title_full | Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses |
title_fullStr | Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses |
title_full_unstemmed | Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses |
title_short | Is Blood Eosinophil Count a Predictor of Response to Bronchodilators in Chronic Obstructive Pulmonary Disease? Results from Post Hoc Subgroup Analyses |
title_sort | is blood eosinophil count a predictor of response to bronchodilators in chronic obstructive pulmonary disease? results from post hoc subgroup analyses |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4579251/ https://www.ncbi.nlm.nih.gov/pubmed/26329916 http://dx.doi.org/10.1007/s40261-015-0322-6 |
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