COPD patients managed in primary care - Proportion of patients potentially eligible for biologic therapy

Background: Acute exacerbations of COPD contribute to high healthcare utilization, morbidity, and premature death. Despite optimal inhaler therapy, many patients continue to experience recurrent exacerbations. Recent studies show that biologic therapy can reduce exacerbation rates in COPD patients with signs of T2 inflammation.

Aims and objectives: To determine the proportion of COPD patients in primary care potentially eligible for biologic therapy.

Methods: In this cross-sectional cohort study participating general practitioners (N=144) recruited patients with COPD currently prescribed inhaled corticosteroids (ICS). Data on demographics, smoking habits, lung function, COPD medication (other than ICS), blood eosinophils, dyspnea score, and exacerbation history were retrieved from medical records. We analyzed proportions and absolute numbers within the study cohort to describe the distribution of patient characteristics and clinical variables.

Results: A total of 2289 COPD patients on ICS were recruited. The final cohort comprised 1817 (55% women; mean age 71 years) patients with complete data on exacerbation history and blood-eosinophil count. A total of 537 patients had a blood eosinophil count >=0.30 x 109 cells/L. Of the 1817 COPD patients, 142 (8%) had at least two moderate exacerbations or one severe exacerbation within the last 12 months together with a blood eosinophil count >=0.30 x 109 cells/L.

Conclusion: In this cohort of COPD patients recruited from primary care and currently prescribed inhaled corticosteroids, 8% were potentially eligible for biologic therapy based on exacerbation history and blood eosinophil count.