Eosinophilia in COPD Patients Predicts Response to Corticosteroids

For patients with chronic obstructive pulmonary disease (COPD) exacerbations, typical treatment is inhaled bronchodilators, antibiotics, and oral corticosteroids. However, not all COPD patients benefit from steroids, and they can have substantial adverse effects.

To determine whether eosinophilia can be used as a marker for response to steroids, 109 patients with frequent COPD exacerbations were randomized to traditional therapy with daily amoxicillin or doxycycline plus prednisolone (30 mg) for 14 days or to “biomarker-directed therapy.” In the biomarker-directed group, patients with peripheral eosinophil counts >2% received prednisolone plus antibiotics, whereas those with eosinophil counts ≤2% received antibiotics only; half of exacerbati…