Eosinopenia in severe COPD exacerbation
Research type
Research Study
Full title
Associates of, and Time to Recovery from, Eosinopenia in severe COPD exacerabtion (A-TREC)
IRAS ID
333785
Contact name
Stephen Bourke
Contact email
Sponsor organisation
Northumbria Healthcare NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Patients with Chronic Obstructive Pulmonary Disease (COPD) often suffer periods with acute worsening of their symptoms, called exacerbations, which are considered severe when they require admission to hospital. The level of a type of white blood cell called eosinophils is used to guide whether long-term treatment with inhaled steroids will help prevent exacerbations. Patients with a higher level of eosinophils experience a greater reduction in exacerbations when treated with inhaled steroids. However, patients with a very low level of eosinophils are unlikely to benefit, but are at risk of side effects such as pneumonia.
During severe exacerbations, blood eosinophils transiently drop to very low levels in half of patients, and this is associated with an increased risk of dying. Similar falls in blood eosinophils are seen in other acute illnesses, including sepsis. We have recently shown that if blood tests taken at hospital admission were used to guide treatment, over 40% of patients would be inappropriately denied inhaled steroids. Unfortunately, this is not yet recognised in current COPD guidelines.
We want to learn when the level of eosinophils in a patient’s blood returns to their normal baseline level following admission to hospital with an exacerbation of their COPD. We will do this by regularly following patients up over a 6-week period after they have had an exacerbation of their COPD and taking blood tests to check their eosinophil level at each visit. This will help us to know the best time to test the level of eosinophils in a patient’s blood after an exacerbation to ensure that they receive the most appropriate inhaled therapy.
We also want to learn what factors may increase a patient's chance of developing very low levels of eosinophils during an exacerbation of COPD as this may provide useful mechanistic information regarding the relationship between BEC and short-term mortality.
REC name
North West - Greater Manchester West Research Ethics Committee
REC reference
23/NW/0346
Date of REC Opinion
19 Jan 2024
REC opinion
Further Information Favourable Opinion