{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T02:43:15Z","timestamp":1781404995452,"version":"3.54.1"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T00:00:00Z","timestamp":1538092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>It remains unclear whether eosinophilia is useful for in guiding inhaled corticosteroid (ICS) therapy in chronic obstructive pulmonary disease (COPD) patients. The goal of this study is to evaluate the risk of acute exacerbations, COPD\u2010related hospitalisations\/accident and emergency visits, and all\u2010cause mortality with various levels of eosinophil counts among COPD patients using ICS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort study was conducted using the UK Clinical Practice Research Datalink. Patients were aged 40+ and had COPD (n\u00a0=\u00a032\u00a0693). Current users of ICS were stratified by relative and absolute eosinophil counts to determine the risk of outcomes with blood eosiniphilia using Cox regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among COPD patients, current use of ICS was not associated with a reduced risk of acute COPD exacerbations, COPD\u2010related hospitalisations\/accident and emergency visits, and all\u2010cause mortality. Stratification of ICS use by absolute or relative eosinophil counts did not result in significant differences in risk of COPD exacerbations or hospitalisations\/accident and emergency visits. However, all\u2010cause mortality was reduced by 12% to 24% among patients with eosinophilia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>COPD\u2010related acute exacerbations or hospitalisations\/accident and emergency visits were not reduced with eosinophilia among users of ICS with COPD. However, all\u2010cause mortality was reduced by 12% to 24%. These findings are potentially important and require further evaluation in prospective studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.4655","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T13:43:17Z","timestamp":1538142197000},"page":"1191-1199","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Blood eosinophilia, use of inhaled corticosteroids, and risk of COPD exacerbations and mortality"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0653-0443","authenticated-orcid":false,"given":"Olorunfemi A.","family":"Oshagbemi","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Toxicology Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"Department of Epidemiology, Care and Public Health Research Institute (CAPHRI) Maastricht University  Maastricht the Netherlands"},{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology Utrecht Institute of Pharmaceutical Sciences  Utrecht the Netherlands"},{"name":"CIRO, Horn  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frits M.E.","family":"Franssen","sequence":"additional","affiliation":[{"name":"CIRO, Horn  the Netherlands"},{"name":"Department of Respiratory Medicine Maastricht University Medical Centre (MUMC+)  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne C.W.","family":"Braeken","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology Utrecht Institute of Pharmaceutical Sciences  Utrecht the Netherlands"},{"name":"CIRO, Horn  the Netherlands"},{"name":"Department of Respiratory Medicine Maastricht University Medical Centre (MUMC+)  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Henskens","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry Maastricht University Medical Centre  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiel F.M.","family":"Wouters","sequence":"additional","affiliation":[{"name":"CIRO, Horn  the Netherlands"},{"name":"Department of Respiratory Medicine Maastricht University Medical Centre (MUMC+)  Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0414-3442","authenticated-orcid":false,"given":"Anke\u2010Hilse","family":"Maitland\u2010van der Zee","sequence":"additional","affiliation":[{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology Utrecht Institute of Pharmaceutical Sciences  Utrecht the Netherlands"},{"name":"Department of Respiratory Medicine, Academic Medical Center (AMC) University of Amsterdam (UvA)  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Burden","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Toxicology Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"Department of Epidemiology, Care and Public Health Research Institute (CAPHRI) Maastricht University  Maastricht the Netherlands"},{"name":"Division of Pharmacoepidemiology and Clinical Pharmacology Utrecht Institute of Pharmaceutical Sciences  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Toxicology Maastricht University Medical Centre  Maastricht the Netherlands"},{"name":"Department of Epidemiology, Care and Public Health Research Institute (CAPHRI) Maastricht University  Maastricht the Netherlands"},{"name":"MRC Lifecourse Epidemiology Unit, Southampton General Hospital  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0218PP"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063070"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61382-8"},{"key":"e_1_2_9_5_1","first-page":"CD010115","article-title":"Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease","volume":"3","author":"Kew KM","year":"2014","journal-title":"Cochrane Database Syst Rev [Internet]"},{"key":"e_1_2_9_6_1","article-title":"Blood eosinophils and exacerbations in COPD: the Copenhagen General Population Study","author":"Vedel\u2010Krogh S","year":"2015","journal-title":"Am J Respir Crit Care Med [Internet]"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00259-3"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)00100-4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0193OC"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201612-2525LE"},{"key":"e_1_2_9_11_1","first-page":"1","article-title":"Predicting frequent asthma exacerbations using blood eosinophil count and other patient data routinely available in clinical practice","volume":"9","author":"Price D","year":"2016","journal-title":"J Asthma Allergy [Internet]"},{"issue":"7","key":"e_1_2_9_12_1","article-title":"Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD\u2010GOLD)","volume":"4","author":"Quint JK","year":"2014","journal-title":"BMJ Open [Internet]"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"issue":"1","key":"e_1_2_9_14_1","first-page":"1","article-title":"The impact of the Quality and Outcomes Framework (QOF) on the recording of smoking targets in primary care medical records: cross\u2010sectional analyses from The Health Improvement Network (THIN) database","volume":"12","author":"Taggar JS","year":"2012","journal-title":"BMC Public Health [Internet]"},{"issue":"59","key":"e_1_2_9_15_1","article-title":"Validation of the recording of acute exacerbations of COPD in the clinical practice research datalink: Phase 1 results","volume":"46","author":"Rothnie K","year":"2015","journal-title":"Eur Respir J [Internet]"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S88759"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006171"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2014.922064"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0151357"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0009LE"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/15412555.2017.1313827"},{"key":"e_1_2_9_22_1","unstructured":"European Medicines Agency.The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) Guide on Methodological Standards in Pharmacoepidemiology (Revision 4). 2015;44(June):1\u201377."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00008612"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200709-148ET"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40248-015-0023-2"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00007613"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201201-0034OC"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00049604"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200611-1630OC"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909883"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-017-9990-8"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201104-0597OC"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00162414"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00258-1"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01370-2015"},{"issue":"5","key":"e_1_2_9_36_1","first-page":"1299 LP\u20101303","article-title":"Blood eosinophil count: a biomarker of an important treatable trait in patients with airway disease","volume":"47","author":"Pavord ID","year":"2016","journal-title":"Eur Respir J [Internet]"},{"issue":"60","key":"e_1_2_9_37_1","article-title":"Relationship between blood eosinophil count (Eos), clinical characteristics and mortality of patients with COPD","volume":"48","author":"Zysman M","year":"2016","journal-title":"Eur Respir J [Internet]"},{"issue":"60","key":"e_1_2_9_38_1","article-title":"Blood eosinophils and outcomes in COPD","volume":"48","author":"Marin Trigo JM","year":"2016","journal-title":"Eur Respir J [Internet]"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-207021"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)30040-6"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S115132"},{"issue":"6","key":"e_1_2_9_42_1","first-page":"261","article-title":"Eosinophilic airway inflammation in chronic obstructive pulmonary disease and asthma","volume":"59","author":"Gorska K","year":"2008","journal-title":"J Physiol Pharmacol [internet]"},{"key":"e_1_2_9_43_1","unstructured":"NHS.Inhaler Repeat Prescriptions [Internet]. 2002 [cited 2017 Jan 4];Available from:http:\/\/www.neneccg.nhs.uk\/resources\/uploads\/files\/Inhaler\u2010Repeat\u2010Prescriptions_Patient information leaflet.pdf"}],"container-title":["Pharmacoepidemiology and Drug Safety"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpds.4655","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pds.4655","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T17:18:38Z","timestamp":1694798318000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pds.4655"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,28]]},"references-count":42,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1002\/pds.4655"],"URL":"https:\/\/doi.org\/10.1002\/pds.4655","archive":["Portico"],"relation":{},"ISSN":["1053-8569","1099-1557"],"issn-type":[{"value":"1053-8569","type":"print"},{"value":"1099-1557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,28]]},"assertion":[{"value":"2017-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}