COPD: elevated blood neutrophils may predict pneumonia risk

  • Pascoe SJ & al.
  • Respir Res
  • 23 Aug 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with chronic obstructive pulmonary disease (COPD), elevated blood neutrophils were associated with subsequent increased risk for pneumonia, irrespective of inhaled corticosteroid (ICS) use.

Why this matters

  • Findings suggest that blood neutrophil count may be a useful novel biomarker in defining treatment pathways in moderate/severe COPD.

Study design

  • Post-hoc meta-analysis of 10 studies involving 10,842 patients (ICS treated, n=6569; non-ICS treated, n=4273)
  • Main outcomes: proportion of patients with pneumonia events and time to the first event stratified by neutrophil count and ICS use.
  • Funding: GlaxoSmithKline plc.

Key results

  • Patients with baseline neutrophil count below the median were at a lower risk for pneumonia events (2.8% vs 3.9%; HR, 0.75; 95% CI; 0.61-0.92) and had a longer time to the first events (52 vs 24 weeks) than those at/above the median neutrophil count.
  • Patients with lower neutrophil counts had similar reductions in the risk for pneumonia compared with those having a higher neutrophil count, irrespective of their treatment with (HR, 0.74; 95% CI, 0.58-0.94; P=.015) or without ICS (HR, 0.77; 95% CI, 0.50-1.17; P=.228).

Limitations

  • Blood neutrophil count was measured at a single time point.