Pneumologie 2021; 75(S 01): S12
DOI: 10.1055/s-0041-1723285
Latebreaking Abstracts 2021

Exacerbation benefit by blood eosinophil counts with budesonide/glycopyrronium/formoterol metered dose inhaler (BGF MDI) at two ICS dose levels in the ETHOS trial: a subgroup analysis

Authors

  • K F Rabe

    1   Lungenclinic Grosshansdorf Gmbh; Zentrum Für Pneumologie Und Thoraxchirurgie; Airway Research Center North (Arcn), Deutsches Zentrum für Lungenforschung (DZL)
  • F J Martinez

    2   New York
  • G T Ferguson

    3   Pulmonary Research Institute of Southeast Michigan, Farmington Hills, MI, USA
  • C Wang

    4   Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital
  • D Singh

    5   Medicines Evaluation Unit Ltd; University of Manchester
  • J Wedzicha

    6   Nationales Herz- und Lungeninstitut, Imperial College London
  • R Trivedi

    7   AstraZeneca
  • E Rose

    7   AstraZeneca
  • S Ballal

    7   AstraZeneca
  • J McLaren

    7   AstraZeneca
  • P Darken

    7   AstraZeneca
  • M Aurivillius

    7   AstraZeneca
  • C Reisner

    7   AstraZeneca
  • P Dorinsky

    7   AstraZeneca
 
 

    Background: For patients who experience COPD exacerbations on LAMA/LABA, GOLD recommends step-up to ICS/LAMA/LABA triple therapy for those with blood eosinophil counts (EOS) ≥ 100 cells/mm3. In the 52-week ETHOS trial (NCT02465567), triple therapy with BGF MDI at two ICS dose levels reduced the rate of moderate/severe COPD exacerbations vs. dual therapies.

    Objective: To assess exacerbation rates in patients with EOS < 100 and ≥ 100 cells/mm3 in ETHOS.

    Methods: Patients with moderate-to-very severe COPD and ≥ 1 moderate/severe exacerbation in the prior year were randomised to BGF MDI 320/14.4/10 µg or 160/14.4/10 µg, glycopyrronium/formoterol (GFF) MDI 14.4/10 µg or budesonide/formoterol (BFF) MDI 320/10 µg (all treatments administered twice-daily in a single Aerosphere inhaler).

    Results: In the modified ITT population (n = 8509), 82.6% of patients had EOS ≥ 100. In these patients, both doses of BGF MDI reduced moderate/severe exacerbations vs. GFF MDI (by 28 – 29%, both p < 0.0001) and BFF MDI (by 11 – 12%, both p < 0.03; Table). In patients with EOS < 100, both BGF MDI doses reduced exacerbations vs. BFF MDI (p < 0.04) but not vs. GFF MDI.

    Conclusions: BGF MDI reduced exacerbations vs. GFF MDI and BFF MDI in patients with EOS ≥ 100 but only vs. BFF MDI in EOS < 100, suggesting this cut-off may be a useful guide for step-up from LAMA/LABA to triple therapy.


    Publikationsverlauf

    Artikel online veröffentlicht:
    30. April 2021

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