Eosinophil levels may predict response to inhaled corticosteriod treatment of COPD- GSK

GSK presented data at the European Respiratory Society (ERS) Congress that show blood eosinophil levels may help predict those patients with COPD who will have a greater reduction in exacerbation rates when receiving an inhaled corticosteroid (ICS) containing regimen, and could potentially be used in the future, if supported by further studies, to help physicians tailor their treatment decisions.

A number of scientific studies have suggested that eosinophils (a type of white blood cell), although primarily associated with asthma, may also influence and be associated with an increased risk of exacerbations among patients with COPD. To explore whether measuring and stratifying patients by blood eosinophil levels could help identify those patients who are likely to derive the most benefit from a particular treatment, GSK undertook a post-hoc analysis of data from almost 8,000 patients to explore whether there was a differential response to treatment based on eosinophil levels measured at study start.

Data were analysed from studies undertaken as part of the development of Relvar Ellipta (fluticasone furoate/vilanterol or FF/VI), an inhaled corticosteroid/long-acting beta2 agonist combination (ICS/LABA) and its individual components, and also Anoro Ellipta (umeclidinium/vilanterol or UMEC/VI), a long-acting muscarinic antagonist/long-acting beta2 agonist (LAMA/LABA) and its individual components.

Post-hoc analysis of data from two randomised, double-blind, placebo-controlled 1-year trials comparing exacerbation rates in patients with moderate to severe COPD, showed that in the subgroup with an eosinophil level greater than 2%, exacerbation rates were reduced by 29% (p<0.001) in those treated with ff vi all doses 50 25mcg 100 25mcg and 200 25mcg compared to vi 25mcg alone. in patients with an eosinophil level of less then 2 a decrease of 10 p="0.283)" was observed between those receiving ff vi and those receiving vi.>

Results from this analysis suggest that baseline eosinophil levels might predict improvement in exacerbation rates in patients taking FF/VI compared to VI alone and that the magnitude of improvement is likely to be greatest in those with the highest levels of eosinophils.