@article{Roche:2017:10.1164/rccm.201701-0193OC,
author = {Roche, N and Chapman, KR and Vogelmeier, CF and Herth, FJ and Thach, C and Fogel, R and Olsson, P and Patalano, F and Banerji, D and Wedzicha, JA},
doi = {10.1164/rccm.201701-0193OC},
journal = {American Journal of Respiratory and Critical Care Medicine},
pages = {1189--1197},
title = {Blood Eosinophils and response to maintenance COPD treatment: data from the FLAME trial},
url = {http://dx.doi.org/10.1164/rccm.201701-0193OC},
volume = {195},
year = {2017}
}

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TY  - JOUR
AB  - Rationale: Post hoc analyses suggest that blood eosinophils have potential as a predictive biomarker of inhaled corticosteroid efficacy in the management of chronic obstructive pulmonary disease (COPD).Objectives: We prospectively investigated the value of blood eosinophils as a predictor of responsiveness to an inhaled corticosteroid/long-acting β2-agonist combination versus a long-acting β2-agonist/long-acting muscarinic antagonist combination for exacerbation prevention.Methods: We conducted prespecified analyses of data from the FLAME (Effect of Indacaterol Glycopyronium vs Fluticasone Salmeterol on COPD Exacerbations) study, which compared once-daily long-acting β2-agonist/long-acting muscarinic antagonist indacaterol/glycopyrronium 110/50 μg with twice-daily long-acting β2-agonist/inhaled corticosteroid salmeterol/fluticasone combination 50/500 μg in patients with one or more exacerbations in the preceding year. Subsequent post hoc analyses were conducted to address further cutoffs and endpoints.Measurements and Main Results: We compared treatment efficacy according to blood eosinophil percentage (<2% and ≥2%, <3% and ≥3%, and <5% and ≥5%) and absolute blood eosinophil count (<150 cells/μl, 150 to <300 cells/μl, and ≥300 cells/μl). Indacaterol/glycopyrronium was significantly superior to salmeterol/fluticasone for the prevention of exacerbations (all severities, or moderate or severe) in the <2%, ≥2%, <3%, <5%, and <150 cells/μl subgroups, and at no cutoff was salmeterol/fluticasone superior to indacaterol/glycopyrronium. Furthermore, the rate of moderate or severe exacerbations did not increase with increasing blood eosinophils. The incidence of pneumonia was higher in patients receiving salmeterol/fluticasone than indacaterol/glycopyrronium in both the <2% and ≥2% subgroups.Conclusions: Our prospective analyses indicate that indacaterol/glycopyrronium provides superior or s
AU  - Roche,N
AU  - Chapman,KR
AU  - Vogelmeier,CF
AU  - Herth,FJ
AU  - Thach,C
AU  - Fogel,R
AU  - Olsson,P
AU  - Patalano,F
AU  - Banerji,D
AU  - Wedzicha,JA
DO  - 10.1164/rccm.201701-0193OC
EP  - 1197
PY  - 2017///
SN  - 1535-4970
SP  - 1189
TI  - Blood Eosinophils and response to maintenance COPD treatment: data from the FLAME trial
T2  - American Journal of Respiratory and Critical Care Medicine
UR  - http://dx.doi.org/10.1164/rccm.201701-0193OC
UR  - http://hdl.handle.net/10044/1/45487
VL  - 195
ER  - 

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