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Med. Sci. 2018, 6(2), 49; https://doi.org/10.3390/medsci6020049

Shall We Focus on the Eosinophil to Guide Treatment with Systemic Corticosteroids during Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)? CON

1
Dirección de Procesos Asistenciales, Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Estructura Organizativa de Xerencia de Xestión Integrada (EOXI) de A Coruña Sergas, Universidade da Coruña (UDC), 15006 A Coruña, Spain
2
Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, 41013 Seville, Spain
3
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
Current Address: Dirección Médica, Hospital de A Coruña, As Xubias de Arriba 84, 15006 A Coruña, Spain
*
Author to whom correspondence should be addressed.
Received: 18 April 2018 / Revised: 25 May 2018 / Accepted: 7 June 2018 / Published: 8 June 2018
(This article belongs to the Special Issue COPD Exacerbations)
View Full-Text   |   Download PDF [324 KB, uploaded 8 June 2018]

Abstract

The employment of systemic corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD) has been shown to improve airway limitation, decrease treatment failure and risk of relapse, and may improve symptoms in addition to decreasing the length of hospital stay. Nowadays, all clinical guidelines recommend systemic corticosteroids to treat moderate or severe COPD exacerbations. However, their use is associated with potential side effects, mainly hyperglycemia. In the era of precision medicine, the possibility of employing blood eosinophil count has emerged as a potential way of optimizing therapy. Issues regarding the intra-individual variability of blood eosinophil count determination, a lack of clear data regarding the real prevalence of eosinophilic acute exacerbations, the fact that previously published studies have demonstrated the benefit of systemic corticosteroids irrespective of eosinophil levels, and especially the fact that there is only one well-designed study justifying this approach have led us to think that we are not ready to use eosinophil count to guide treatment with systemic corticosteroids during acute exacerbations of COPD. View Full-Text
Keywords: Chronic obstructive pulmonary disease (COPD); acute exacerbation; eosinophil; precision medicine; systemic corticosteroids Chronic obstructive pulmonary disease (COPD); acute exacerbation; eosinophil; precision medicine; systemic corticosteroids
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Marcos, P.J.; López-Campos, J.L. Shall We Focus on the Eosinophil to Guide Treatment with Systemic Corticosteroids during Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)? CON. Med. Sci. 2018, 6, 49.

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