Reply to: Is there a kindling effect in COPD exacerbations?

Abstract

Extract We thank A.I. Papaioannou and K. Bartziokas for their interest in our study of the relationship between exacerbation history and blood eosinophil count prior to a diagnosis of COPD and the risk of subsequent exacerbations [1]. As they point out, it is well known that in patients with an established diagnosis and on maintenance treatment, the prior exacerbation history is the best predictor of future exacerbation risk, but our study was the first to show that in newly diagnosed patients, a single exacerbation prior to diagnosis of COPD is associated with a significant risk of exacerbations over the next 12 months and more frequent or severe exacerbations prior to diagnosis are associated with a higher risk.