Late Breaking Abstract - Association between blood eosinophils and exacerbation risk in COPD primary care

Background: Blood eosinophil count (eos) is a potential predictor of COPD exacerbation risk modifiable by inhaled corticosteroids (ICS). We aimed to describe this association by ICS use. Methods: Retrospective cohort of COPD patients from the UK Clinical Practice Research Datalink with a stable-state eos value recorded Jan 2004-Dec 2013 were followed to Dec 2014 for exacerbation events. Negative binomial models, adjusted for COPD severity, fitted to produce exacerbation incidence rate ratios for incremental categories of eos (cells/µL), stratified by a time-varying measure of ICS use. Acute exacerbations were defined using a validated algorithm; severe exacerbations required hospitalization. Results: 17,495 patients were included; 53% male, mean age 72 yrs. Mean follow-up time on ICS=1.79 yrs; not on ICS=0.93 yrs. During time when not taking ICS, a “U-shaped” relationship was seen where patients with lower ( Conclusions: Consistent with clinical trials, these data suggest an association between eos level and COPD exacerbation risk, particularly for severe events, among patients not on ICS. This may suggest ICS can lower exacerbation risk in patients with higher eos. GSK Sponsored Study: PRJ2557