The document discusses two studies related to COPD exacerbations and biomarkers. The first study re-analyzed data from a previous 3-year study to determine if inhaled corticosteroids reduce the rate of lung function decline in COPD patients with an eosinophil count of 2% or higher. The re-analysis found that patients with an eosinophil count of 2% or higher experienced a slower rate of lung function decline when treated with inhaled corticosteroids. The second study analyzed sputum samples from 68 COPD patients taken at exacerbation presentation and during recovery. It found that exacerbations associated with human rhinovirus infection were related to higher COPD Assessment Test scores, suggesting

1. Mesa 2. Control y biomarcadores
Dr. Borja García-
Cosío Piqueras
Hospital Universitario Son Espases.
Mallorca

2. Mesa 2. Control y biomarcadores
[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

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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

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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 %).

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Results
• Eosinophil count was <2 % in 68 % of patients; the spirometric
characteristics of these patients were similar to those with an eosinophil
count ≥2 %.

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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

7. Mesa 2. Control y biomarcadores
[ATS] Human Rhinovirus
Infection And CAT Scores
During COPD
Exacerbations
George SN, Mackay AJ, et al.

8. Mesa 2. Control y biomarcadores
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.

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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.

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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.

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Discussion
• Conclusion: This suggests that exacerbations associated with HRV
infection have a greater impact on patient’s health status.

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