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Rigshospitalet - a part of Copenhagen University Hospital
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Corticosteroid Resistance in Smokers-A Substudy Analysis of the CORTICO-COP Randomised Controlled Trial

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  • Pradeesh Sivapalan
  • Andras Bikov
  • Charlotte Suppli Ulrik
  • Therese Sophie Lapperre
  • Alexander G Mathioudakis
  • Mats Christian Højberg Lassen
  • Kristoffer Grundtvig Skaarup
  • Tor Biering-Sørensen
  • Jørgen Vestbo
  • Jens-Ulrik S Jensen
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The CORTICO-COP trial showed that eosinophil-guided corticosteroid-sparing treatment for acute exacerbation of chronic obstructive pulmonary disease was non-inferior to standard of care and decreased the accumulated dose of systemic corticosteroids that patients were exposed to by approximately 60%. Smoking status has been shown to affect corticosteroid responsiveness. This post hoc analysis investigated whether eosinophil-guided treatment is non-inferior to conventional treatment in current smokers. The main analysis of current smokers showed no significant difference in the primary endpoint, days alive, and out of hospital within 14 days between the control group (mean, 9.8 days; 95% confidence interval (CI), 8.7-10.8) and the eosinophil-guided group (mean, 8.7 days; 95% CI, 7.5-9.9; p = 0.34). Secondary analyses of the number of exacerbations or deaths, the number of intensive care unit admissions or deaths, lung function improvement, and change in health-related quality of life also showed no significant differences between the two groups. The results of a sensitivity analysis of ex-smokers are consistent with the main analysis. Our results suggest that eosinophil-guided treatment is non-inferior to standard of care in current smokers and ex-smokers. Because data on the impact of smoking status on eosinophil-guided treatments are sparse, more randomised trials are needed to confirm our results.

Original languageEnglish
Article number2734
JournalJournal of Clinical Medicine
Volume10
Issue number12
Pages (from-to)1-11
Number of pages11
ISSN2077-0383
DOIs
Publication statusPublished - 21 Jun 2021

    Research areas

  • airway inflammation, blood eosinophils, chronic obstructive pulmonary disease, corticosteroid resistance, smoking, Blood eosinophils, Corticosteroid resistance, Chronic obstructive pulmonary disease, Airway in-flammation, Smoking

ID: 66573543