Blood eosinophil counts in COPD - version 1
Research type
Research Study
Full title
Influence of reliance on historical blood eosinophil counts on ICS prescribing by GOLD 2019 thresholds in COPD
IRAS ID
285200
Contact name
Stephen Bourke
Contact email
Sponsor organisation
Northumbria Healthcare NHS Foundation Trust
Duration of Study in the UK
2 years, 6 months, 3 days
Research summary
There is a commonly performed blood test that helps to predict how much benefit an individual patient with COPD is likely to obtain from taking inhaled steroids. If the level of the blood test (known as the blood eosinophil count) is high, the patient is more likely to benefit from inhaled steroids. In patients with very low levels of eosinophils, the potential harm from inhaled steroids (for example the risk of pneumonia) may be greater than the benefits.
Both UK and international guidelines now recommend that this blood test is used to help guide the use of inhaled steroids, but do not advise on when the blood test should be taken. In real life, doctors and respiratory nurses often see patients when they are unwell. This is a potential problem, because when patients are unwell their blood eosinophil count often falls to a low level for several days. Decisions based on this result may lead to patients who would benefit from inhaled steroids (those who normally have a higher blood eosinophil count when stable) not being given inhaled steroids. On the other hand, if treatment decisions are delayed until patients have recovered and had the blood test performed again, this would require additional clinic visits and delay treatment during a period when patients are often more at risk.
Patients with COPD have often had multiple previous blood eosinophil counts performed, and some are likely to have been measured when they have recovered after an illness or at other times when they were stable.
Our study will look at blood eosinophil counts when the patient is confirmed to be stable and compare them to the highest of at least three blood eosinophil counts performed within the last two years to see how often they agree, particularly in terms of treatment decisions.
REC name
London - Surrey Research Ethics Committee
REC reference
20/PR/0427
Date of REC Opinion
28 Sep 2020
REC opinion
Further Information Favourable Opinion