Mesa 2.2. borja garcía cosió

Mesa 2. Control y biomarcadores

Dr. Borja García-

Cosío Piqueras

Hospital Universitario Son Espases.

Mallorca


[ATS] Do Inhaled

Corticosteroids (ICS)

Reduce Rate Of Decline Of

Lung Function In

COPD Patients With

Eosinophil Count ≥ 2%?

Barnes N, Sharma R, Lettis S,

Calverley PM


Background and objectives

• COPD patients with a blood eosinophil count ≥2 % show a greater reduction in exacerbations when given ICS.

• Whether the same is true for rate of decline of lung function is unknown.

Pascoe et al. Lancet Resp Med 2015


Methods

• The results of ISOLDE (FLTB3054) (Burge PS et al BMJ

2000;320:1297–303), a 3-year study of the effects of FP 500mcg

twice daily on rate of decline of FEV1 in well-characterised COPD

patients were re-analysed by baseline blood eosinophil count (≥2 %,

<2 %).


Results• Eosinophil count was <2 % in 68 % of patients; the spirometric

characteristics of these patients were similar to those with an eosinophil count ≥2 %.


Discussion

• A baseline blood eosinophil count of ≥2 % identifies a group of

COPD patients who show a slower rate of decline of FEV1 when

treated with ICSs.

Xuan W et al. Am J Resp Crit Care Med 2000


[ATS] Human Rhinovirus

Infection And CAT Scores

During COPD

Exacerbations

George SN, Mackay AJ, et al.


Background and objectives

• Human rhinovirus (HRV) is the main aetiological

agent of virus-associated COPD exacerbations

(Seemungal et al. ARJCCM 2001)

• The COPD Assessment Test (CAT) scores have

been shown to increase at COPD exacerbation

(Mackay et al. AJRCCM 2012).

• Authors hypothesized that HRV prevalence and

load relate to CAT scores.


Methods

• Real-time quantitative-PCR was used to assess HRV prevalence and load in sputum samples taken at exacerbation presentation, and during recovery at Days 3, 7, 14, 35 and 56 thereafter.

• Exacerbations were defined as an increase in at least two respiratory symptoms for two consecutive days, recorded on prospectively-completed daily diary cards, with at least one symptom being a major symptom; dyspnoea, sputum purulence or volume (Seemungal et al. ARJCCM 1998).

• Patients completed a paper version of the CAT diary at each clinic visit based on the symptoms they experienced that day.


Results

• Sixty-eight patients with moderate to severe COPD (mean age 72.9 years (SD±7.6); stable state FEV1

48.9 % predicted (±19.6 %); FEV1 /FVC 0.46 (±0.1); FEV1 1.18L (±0.5); current smoker 33 %; male

gender 63 %) recorded CAT scores for 388 sputum samples taken at different time points during

exacerbation and recovery.


Discussion

• Conclusion: This suggests that exacerbations associated with HRV

infection have a greater impact on patient’s health status.


Muchas gracias

por su atención

Health & Medicine

Mesa 2.2. borja garcía cosió