COPD with High-Risk Eosinophilic Phenotype: Blood Eosinophils ≥ 300 cells/µL
In COPD, identifying the eosinophilic phenotype at high exacerbation risk is a key step that directly determines the recommended treatment approach. This protocol addresses that specific subgroup.
Clinical Scenario
This protocol applies to patients with COPD who meet the criteria for a high-risk eosinophilic phenotype: blood eosinophils ≥ 300 cells/µL, together with two or more moderate exacerbations, or at least one exacerbation requiring hospitalisation, in the previous year.
Treatment Approach
For this high-risk eosinophilic subgroup, the recommended initial therapy is an inhaled corticosteroid combined with a long-acting beta2-agonist. The complete structured protocol defines the full regimen details and sequencing for this phenotype.
References
DOI: 10.3390/jcm13020303
On the other hand, patients at high risk should be differentiated by phenotype: in the case of a non-acute and non-eosinophilic patient, treatment should be initiated with LABA + LAMA, and in the case of an eosinophilic patient, treatment should be initiated with IC + LABA (Figure 1).
Also, it proposes to initiate triple therapy (LABA + LAMA + IC) in patients with ≥300/µL blood eosinophils consistently and two or more moderate exacerbations or in those whose onset required an admission (Figure 2).
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