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Comparative Study
. 2017 Jun 20:12:1819-1824.
doi: 10.2147/COPD.S129787. eCollection 2017.

Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

Maeva Zysman  1 , Gaëtan Deslee  2 , Denis Caillaud  3 , Pascal Chanez  4 , Roger Escamilla  5 , Isabelle Court-Fortune  6 , Pascale Nesme-Meyer  7 , Thierry Perez  8 , Jean-Louis Paillasseur  9 , Christophe Pinet  10 , Gilles Jebrak  11 , Nicolas Roche  12 , Pierre-Régis Burgel  12
Affiliations
Comparative Study

Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

Maeva Zysman et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

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.

Keywords: COPD; eosinophils; exacerbations; quality of life; survival.

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Conflict of interest statement

Disclosure Dr Zysman reports grants and personal fees from Boehringer Ingelheim and personal fees from Novartis, Chiesi, AGEvie outside the submitted work. Dr Deslee reports personal fees from Novartis, AstraZeneca, BTG/PneumRx, Chiesi, and Boehringer Ingelheim, outside the submitted work. Dr Caillaud reports grants and personal fees from Boehringer Ingelheim, personal fees from Novartis, Bayer, and grants from AstraZeneca, ALK-Abello, and Stallergenes, outside the submitted work. Dr Chanez does not report any conflicts of interest. Dr Escamilla reports grants and personal fees from Boehringer Ingelheim, Novartis, personal fees from AstraZeneca, Mundipharma, ALK, and Chiesi, and nonfinancial support from TEVA, outside the submitted work. Dr Court-Fortune reports grants and personal fees from Boehringer Ingelheim and Novartis. Dr Nesme-Meyer reports grants and personal fees from Boehringer Ingelheim. Dr Perez reports personal fees from Boehringer Ingelheim, Novartis, GSK, Chiesi, and Pierre Fabre, outside the submitted work. Dr Paillasseur reports grants from Initiative BPCO Association, during the conduct of the study. Dr Pinet reports grants and personal fees from Boehringer Ingelheim and Novartis. Dr Jebrak reports grants and personal fees from Boerhringer, Novartis, and Pfizer and personal fees from AstraZeneca during the conduct of the study. Dr Roche reports grants and personal fees from Boehringer Ingelheim, Novartis, and Pfizer and personal fees from Teva, GSK, AstraZeneca, Chiesi, Mundipharma, Cipla, Sanofi, Sandoz, Zambon, 3M, and BRAHMS/Thermo Fischer scientific, outside the submitted work. Dr Burgel reports grants and personal fees from Boehringer Ingelheim and personal fees from Aptalis, Astra-Zeneca, Chiesi, GSK, Novartis, Pfizer, Vertex, and Zambon, outside the submitted work.

Figures

Figure 1
Figure 1
Kaplan–Meier analysis for comparison of survival between COPD patients with high versus low eosinophils using the 2% blood eosinophil cutoff.
Figure 2
Figure 2
Kaplan–Meier analysis for comparison of survival between COPD patients with four different blood eosinophil cutoffs: <2%, ≥2% and <3%, ≥3% and <4%, and ≥4%.
See this image and copyright information in PMC

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