Burden of disease associated with a COPD eosinophilic phenotype

Ortega, Héctor; Llanos, Jean-Pierre; Lafeuille, Marie-Hélène; Germain, Guillaume; Duh, Mei Sheng; Bell, Christopher F.; Sama, Susan; Hahn, Beth

doi:10.2147/copd.s170995

Cited by 21 publications

(26 citation statements)

References 19 publications

(22 reference statements)

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“…Data on the impact of elevated blood eosinophil counts in patients with COPD were reported in a recent cross-sectional study in the USA. Those individuals with a blood eosinophil count ≥150 cells/µL were shown to have higher all-cause and COPD-related HCRU and costs compared with those with a blood eosinophil count <150 cells/µL 24. Taken together with our results, these findings suggest that blood eosinophil counts may be a useful biomarker for assessing disease burden in patients with COPD and identifying those who may benefit from alternative treatment strategies.…”

Section: Discussionsupporting

confidence: 76%

The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization

Viinanen

Lassenius²,

Toppila³

et al. 2019

COPD

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PurposeThe burden associated with chronic obstructive pulmonary disease (COPD) is substantial. The objectives of this study were to describe healthcare resource utilization (HCRU) and HCRU-associated costs in patients with COPD in Finland, according to disease severity and blood eosinophil count (BEC).Patients and methodsThis non-interventional, retrospective registry study (GSK ID: HO-17-17558) utilized data from the specialist care hospital register. Data extraction was from first hospital visit with a COPD diagnosis (index date) from January 1, 2004 until December 31, 2015 or death. Patients (aged >18 years with ≥1 report of post-bronchodilation forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7) were categorized as having non-severe or severe COPD (FEV1 >50% or ≤50% of reference, respectively). Patients who were initially non-severe but progressed to severe were classified as having progressing COPD. Patients without spirometry registry data were classified as having clinically verified COPD. Patients were grouped according to BEC (≥300 cells/μL, <300 cells/μL or BEC unknown). HCRU, estimated associated costs and mortality were evaluated according to COPD severity and BEC.ResultsThere were 9042 patients with COPD; 340 non-severe, 326 progressing, 394 severe, and 7982 clinically verified. BEC was available for 31.8% of patients. The mean follow-up time was 3.7–6.5 years in the classified patient-groups. All-cause mortality was 46% during follow-up. Severe COPD was associated with more COPD-related HCRU and higher mortality than non-severe COPD. Patients with BEC ≥300 cells/μL had higher overall HCRU but improved survival compared with those with BEC <300 cells/μL. Overall direct costs were similar across COPD severity categories, 3300–3900€/patient-year, although COPD-related costs were higher in patients with severe versus non-severe COPD.ConclusionThis study demonstrated a substantial burden associated with severe and/or eosinophilic COPD for patients in Finland.

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Section: Discussionsupporting

confidence: 76%

The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization

Viinanen

Lassenius²,

Toppila³

et al. 2019

COPD

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“…A higher rate of study outcomes in the population with the study phenotype was expected and driven by the definition of these traits, namely history of exacerbations. A recent study also reported that patients with COPD who had an eosinophil count >150 cells/µL had higher all-cause and COPD-related healthcare costs than those with an eosinophil count <150 cells/µL 33. Taken together, these results highlight the high clinical burden of illness among patients with this phenotype and suggest that these individuals have a more severe disease course than other patients with COPD who do not meet the study phenotype criteria.…”

Section: Discussionmentioning

confidence: 65%

Clinical burden of illness among patients with severe eosinophilic COPD

Müllerová¹,

Meeraus²,

Galkin³

et al. 2019

COPD

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Background: There are currently limited real-world data on the clinical burden of illness in patients with COPD who continue to exacerbate despite receiving triple therapy. The aim of this study was to compare the burden of COPD in patients with and without a phenotype characterized by a high blood eosinophil count and high risk of exacerbations while receiving triple therapy. Methods: This retrospective cohort study (GSK ID: 207323/PRJ2647) used UK Clinical Practice Research Datalink records linked with Hospital Episode Statistics. Eligible patients had a COPD medical diagnosis code recorded between January 1, 2004 and December 31, 2014, and a blood eosinophil count recorded on/after that date. Patients were followed from index date (first qualifying blood eosinophil count) until December 31, 2015. The study phenotype was defined as ≥2 moderate/≥1 severe acute exacerbation of COPD (AECOPD) in the year prior to the index date, current use of multiple-inhaler triple therapy (MITT), and blood eosinophil count ≥150 cells/µL on the index date. Outcomes measured during follow-up included moderate/severe AECOPDs, severe AECOPDs, all-cause mortality, primary care (GP) clinical consultations, and non-AECOPD-related unscheduled hospitalizations. Results: Of 46,814 patients eligible for inclusion, 2512 (5.4%) met the definition of the study phenotype. Adjusted rate ratios (95% CI) of moderate/severe AECOPDs and all-cause mortality in patients with the study phenotype versus those without were 2.32 (2.22, 2.43) and 1.26 (1.16, 1.37), respectively. For GP visits and non-AECOPD-related unscheduled hospitalizations, adjusted rate ratios (95% CI), in patients with the study phenotype versus those without, were 1.09 (1.05, 1.12) and 1.31 (1.18, 1.46), respectively. Conclusion: Patients with COPD and raised blood eosinophil counts who continue to exacerbate despite MITT represent a distinct subgroup who experience substantial clinical burden and account for high healthcare expenditure. There is a need for more effective management and therapeutic options for these patients.

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“…11 Two recent US studies on patients with COPD have also found an increase in healthcare resource utilization with increasing eosinophil count. 12,13 This retrospective, observational database study of COPD patients spanning multiple real-world US practice settings is the first comprehensive evaluation of the association of blood eosinophil counts with health care utilization and cost outcomes reflecting current clinical practice across the US. The aims of this cohort study were to describe patient characteristics, health care utilization and cost across groups with increasing blood eosinophil counts in a broadly representative COPD patient population.…”

Section: Introductionmentioning

confidence: 99%

Clinical And Economic Burden Of Eosinophilic COPD In A Large Retrospective US Cohort

Trudo

Kallenbach

Vasey

et al. 2019

COPD

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Purpose: We sought to describe clinical and economic outcomes for COPD patients by blood eosinophil (EOS) count. Methods: This retrospective cohort study of COPD patients used data from the Practice Fusion electronic medical records (EMR) database linked to Symphony Health Solutions transactional pharmacy, medical, outpatient, and inpatient claims data to evaluate COPD-related and all-cause health care resource utilization and cost in the 12-month period following the date of each patient's greatest recorded blood eosinophil count during the 27-month period from January 2014 to March 2016. A post-index moderate exacerbation was defined as an outpatient or emergency care visit for COPD and a prescription for oral corticosteroid and/or antibiotics within 10 days of the visit. Severe exacerbation was defined as an inpatient hospitalization with COPD as primary diagnosis. Results: Of 48,090 EMR patients, 39,939 (83.1%) had a charge in the claims data both preand post-index (mean age 67.2 years, 58.3% female), 17,397 (43.6%) had EOS ≥220 cells/µL. Moderate and severe exacerbations were more frequent for patients with EOS≥220 cells/µL compared with those with EOS <220 cells/µL (moderate: 6.8% vs 6.1%, p<0.05; severe: 3.1% vs 2.5%, p<0.001). After adjustment for baseline clinical characteristics, each 100-unit increase in EOS count was associated with a significant 2.24% increase in total all-cause costs and 4.54% increase in total COPD-related costs (p<0.001 for both). COPD-related costs were significantly greater for patients with an EOS count of ≥220 cells/µL compared with those with EOS <220 cells/µL (p<0.001). These costs appear to have been driven by a greater percentage of patients in the ≥220 cells/µL cohort with COPD-related resource use including hospitalization, office visits, ambulatory procedures and pharmacy prescriptions. Conclusion: COPD patients with EOS counts ≥220 cells/µL were more likely to have had moderate or severe exacerbations and greater cost of care than those with EOS <220 cells/µL.

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Burden of disease associated with a COPD eosinophilic phenotype

Cited by 21 publications

References 19 publications

<p>The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization</p>

<p>The Burden Of Chronic Obstructive Pulmonary Disease (COPD) In Finland: Impact Of Disease Severity And Eosinophil Count On Healthcare Resource Utilization</p>

<p>Clinical burden of illness among patients with severe eosinophilic COPD</p>

<p>Clinical And Economic Burden Of Eosinophilic COPD In A Large Retrospective US Cohort</p>

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