Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.

BACKGROUND: An association between the sputum eosinophil count and the response to a 2 week course of prednisolone has previously been reported in patients with chronic obstructive pulmonary disease (COPD). Whether the response to inhaled corticosteroids is related to the presence of eosinophilic in...

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Main Authors: Brightling, C, McKenna, S, Hargadon, B, Birring, S, Green, R, Siva, R, Berry, M, Parker, D, Monteiro, W, Pavord, I, Bradding, P
Format: Journal article
Language:English
Published: 2005
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author Brightling, C
McKenna, S
Hargadon, B
Birring, S
Green, R
Siva, R
Berry, M
Parker, D
Monteiro, W
Pavord, I
Bradding, P
author_facet Brightling, C
McKenna, S
Hargadon, B
Birring, S
Green, R
Siva, R
Berry, M
Parker, D
Monteiro, W
Pavord, I
Bradding, P
author_sort Brightling, C
collection OXFORD
description BACKGROUND: An association between the sputum eosinophil count and the response to a 2 week course of prednisolone has previously been reported in patients with chronic obstructive pulmonary disease (COPD). Whether the response to inhaled corticosteroids is related to the presence of eosinophilic inflammation is unclear. METHODS: A randomised, double blind, crossover trial of placebo and mometasone furoate (800 microg/day), each given for 6 weeks with a 4 week washout period, was performed in subjects with COPD treated with bronchodilator therapy only. Spirometric tests, symptom scores, chronic respiratory disease questionnaire (CRQ), and induced sputum were performed before and after each treatment phase. RESULTS: Ninety five patients were recruited of which 60 were randomised. Overall there were no treatment associated changes in forced expiratory volume in 1 second (FEV(1)), total CRQ, or sputum characteristics. After stratification into tertiles by baseline eosinophil count, the net improvement in post-bronchodilator FEV(1) increased with mometasone compared with placebo progressively from the least to the most eosinophilic tertile. The mean change in post-bronchodilator FEV(1) with mometasone compared with placebo in the highest tertile was 0.11 l (95% CI 0.03 to 0.19). This improvement was not associated with a fall in the sputum eosinophil count. CONCLUSIONS: An increased sputum eosinophil count is related to an improvement in post-bronchodilator FEV(1) following treatment with inhaled mometasone in COPD, but the improvement is not associated with a reduction in the sputum eosinophil count.
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spelling oxford-uuid:a2c149ba-5d06-4738-ba90-0ea83d943ea52022-03-27T02:22:17ZSputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a2c149ba-5d06-4738-ba90-0ea83d943ea5EnglishSymplectic Elements at Oxford2005Brightling, CMcKenna, SHargadon, BBirring, SGreen, RSiva, RBerry, MParker, DMonteiro, WPavord, IBradding, PBACKGROUND: An association between the sputum eosinophil count and the response to a 2 week course of prednisolone has previously been reported in patients with chronic obstructive pulmonary disease (COPD). Whether the response to inhaled corticosteroids is related to the presence of eosinophilic inflammation is unclear. METHODS: A randomised, double blind, crossover trial of placebo and mometasone furoate (800 microg/day), each given for 6 weeks with a 4 week washout period, was performed in subjects with COPD treated with bronchodilator therapy only. Spirometric tests, symptom scores, chronic respiratory disease questionnaire (CRQ), and induced sputum were performed before and after each treatment phase. RESULTS: Ninety five patients were recruited of which 60 were randomised. Overall there were no treatment associated changes in forced expiratory volume in 1 second (FEV(1)), total CRQ, or sputum characteristics. After stratification into tertiles by baseline eosinophil count, the net improvement in post-bronchodilator FEV(1) increased with mometasone compared with placebo progressively from the least to the most eosinophilic tertile. The mean change in post-bronchodilator FEV(1) with mometasone compared with placebo in the highest tertile was 0.11 l (95% CI 0.03 to 0.19). This improvement was not associated with a fall in the sputum eosinophil count. CONCLUSIONS: An increased sputum eosinophil count is related to an improvement in post-bronchodilator FEV(1) following treatment with inhaled mometasone in COPD, but the improvement is not associated with a reduction in the sputum eosinophil count.
spellingShingle Brightling, C
McKenna, S
Hargadon, B
Birring, S
Green, R
Siva, R
Berry, M
Parker, D
Monteiro, W
Pavord, I
Bradding, P
Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.
title Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.
title_full Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.
title_fullStr Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.
title_full_unstemmed Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.
title_short Sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease.
title_sort sputum eosinophilia and the short term response to inhaled mometasone in chronic obstructive pulmonary disease
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