Patients with COPD who had higher blood eosinophil counts (≥220 cells per microliter) were significantly more likely to experience symptom exacerbations that are moderate or severe in intensity and to have greater cost of care than patients who had lower blood eosinophil counts, according to a real-world study published in the International Journal of Chronic Obstructive Pulmonary Disease. The difference in cost appeared to originate from higher COPD-related resource use, including hospitalizations, office visits, ambulatory procedures, and prescriptions.
This retrospective cohort study, conducted by researchers from AstraZeneca and Veradigm, used data sourced from a nationwide, electronic health record platform, linked to transactional administrative claims.1 The study provides the first comprehensive evaluation of blood eosinophil count, healthcare utilization, and cost as reflected in current clinical practice across the United States.
COPD describes a group of lung diseases that includes chronic bronchitis and emphysema. Its natural history often includes progressive airflow obstruction, lung function decline, and periodic exacerbations that require hospitalization; these exacerbations may even be fatal. As a type of white blood cell, eosinophils protect against microbial invaders and play a key role in allergic responses and inflammation. Eosinophils hold the potential to be useful as biomarkers in guiding therapy, as levels of eosinophils in blood have been shown to predict the risk of exacerbations and clinical response to inhaled corticosteroids in patients with COPD.2
In their paper, the authors concluded that “the data are sufficiently impactful to suggest that providers obtain eosinophil counts for COPD risk stratification when making decisions regarding inhaled corticosteroid use.” They suggest that future studies will be useful in elucidating whether a biomarker-driven approach can affect cost and clinical outcomes in COPD patients with an eosinophilic phenotype.
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- Trudo F, Kallenbach L, Vasey J, et al. Clinical and economic burden of eosinophilic COPD in a large retrospective US cohort. Int J Chronic Ob Pulmonary Dis 2019:14:2625-2637. doi:10.2147COPD.S220009.
- Bafadhel M, Peterson S, De Blas MA, et al. Predictors of exacerbation risk and response to budesonide in patients with chronic obstructive pulmonary disease: a post-hoc analysis of three randomised trials. Lancet Respir Med 2018;6(2):117-126. doi:10.1016S2213-2600(18)30006-7.