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Blood eosinophils in COPD: are biologics for everyone?
Marco Vanetti1,2, Dina Visca3,4, Francesco Ardesi3,4
1Department of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Via Crotto Roncaccio 16, Tradate 21049, Italy.
Background:
Type 2 (T2) biologics represent a promising treatment option for chronic obstructive pulmonary disease (COPD) patients with eosinophilic inflammation.
Objectives:
To evaluate the prevalence of stable COPD patients who may be eligible for T2 biologics.
Design:
Real-world, retrospective, monocentric study in COPD patients undergoing inpatient pulmonary rehabilitation.
Methods:
Clinical, functional, and inflammatory data were collected. Patients were considered eligible for T2 biologic therapy whether they were receiving optimized inhaled therapy and had a history of ⩾2 moderate and/or ⩾1 severe exacerbations in the previous year, together with a blood eosinophil count ⩾300 cells/μL.
Results:
Among 441 patients, 21.5% had blood eosinophil counts ⩾300 cells/μL and 6.8% fulfilled the combined eligibility criteria. A high burden of respiratory and cardiometabolic comorbidities and increased cardiovascular risk was observed in the overall population.
Conclusion:
Only a subgroup of patients seems eligible for biologics, treatment escalation should be based on optimized standard care management and patient phenotyping.
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