Trial reportAmerican journal of respiratory and critical care medicine2012
Blood eosinophils to direct corticosteroid treatment of exacerbations of chronic obstructive pulmonary disease: a randomized placebo-controlled trial.
Trial report in American journal of respiratory and critical care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 267 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Biomarker Guided Decision-making in Acute Exacerbation of COPD: a Feasibility Study
A Two-center, Randomized, Double-blind, Placebo-controlled Study of Intravenous Plasma-purified Alpha-1 Antitrypsin for Hospitalized Patients With COPD Exacerbations (AECOPD Study)
Who cites it
267 citing papers in PubMed, 7 syntheses or guidelines pooled it, 596 citations in OpenAlex.
- InhaledEuropean respiratory review : an official journal of the European Respiratory Society · 2024Pooled it
- Blood eosinophil counts in the general population and airways disease: a comprehensive review and meta-analysis.The European respiratory journal · 2022Pooled it
- Mepolizumab for Eosinophil-Associated COPD: Analysis of METREX and METREO.International journal of chronic obstructive pulmonary disease · 2021Pooled it
- Prevalence and Baseline Clinical Characteristics of Eosinophilic Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review.Frontiers in medicine · 2019Pooled it
- Mepolizumab in the treatment of eosinophilic chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2019Pooled it
- Blood eosinophils and inhaled corticosteroids in patients with COPD: systematic review and meta-analysis.International journal of chronic obstructive pulmonary disease · 2018Pooled it
- Eosinophilia and clinical outcome of chronic obstructive pulmonary disease: a meta-analysis.Scientific reports · 2017Pooled it
- Trial
- Effect of Telemonitoring on Moderate and Severe Exacerbations in Patients with COPD: Pooled Analysis of Two Randomized Controlled Trials in Denmark.International journal of chronic obstructive pulmonary disease · 2025Trial
- Treatment failure and hospital readmissions in severe COPD exacerbations treated with azithromycin versus placebo - a post-hoc analysis of the BACE randomized controlled trial.Respiratory research · 2019Trial
- SputumInternational journal of chronic obstructive pulmonary disease · 2019Trial
- Increased serum amyloid A in nasal polyps is associated with systemic corticosteroid insensitivity in patients with chronic rhinosinusitis with nasal polyps: a pilot study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2018Trial
- Trial
- A multi-center randomized, controlled, open-label trial evaluating the effects of eosinophil-guided corticosteroid-sparing therapy in hospitalised patients with COPD exacerbations - The CORTICO steroid reduction in COPD (CORTICO-COP) study protocol.BMC pulmonary medicine · 2017Trial
- Eosinophil biology in COPD: from scientific insight to clinical treatment action.ERJ open research · 2026Review
- Eosinophil Extracellular Traps in Health and Disease: From Host Defense to Chronic Inflammation.Biomedicines · 2026Review
- Blood eosinophil counts and postoperative outcomes in early-stage lung cancer: a retrospective cohort study.Respiratory research · 2026Article
- Epithelial cells in chronic obstructive pulmonary disease exacerbations: Targets for lung repair.Pharmacological reviews · 2026Review
- Beyond Triple Therapy: Anti-Type 2 Biologic Therapies for Eosinophilic COPD and Respiratory Comorbidities - a Review of Clinical Evidence.Current allergy and asthma reports · 2026Review
- Blood eosinophil count as a biomarker for therapy guidance in COPD and asthma exacerbations.Breathe (Sheffield, England) · 2026Article
207 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
rationaleExacerbations of chronic obstructive pulmonary disease (COPD) and responses to treatment are heterogeneous.
objectivesInvestigate the usefulness of blood eosinophils to direct corticosteroid therapy during exacerbations.
methodsSubjects with COPD exacerbations were entered into a randomized biomarker-directed double-blind corticosteroid versus standard therapy study. Subjects in the standard arm received prednisolone for 2 weeks, whereas in the biomarker-directed arm, prednisolone or matching placebo was given according to the blood eosinophil count biomarker. Both study groups received antibiotics. Blood eosinophils were measured in the biomarker-directed and standard therapy arms to define biomarker-positive and -negative exacerbations (blood eosinophil count > and ≤ 2%, respectively). The primary outcome was to determine noninferiority in health status using the chronic respiratory questionnaire (CRQ) and in the proportion of exacerbations associated with a treatment failure between subjects allocated to the biomarker-directed and standard therapy arms. MEASUREMENTS AND MAIN
resultsThere were 86 and 80 exacerbations in the biomarker-directed and standard treatment groups, respectively. In the biomarker-directed group, 49% of the exacerbations were not treated with prednisolone. CRQ improvement after treatment in the standard and biomarker-directed therapy groups was similar (0.8 vs. 1.1; mean difference, 0.3; 95% confidence interval, 0.0-0.6; P = 0.05). There was a greater improvement in CRQ in biomarker-negative exacerbations given placebo compared with those given prednisolone (mean difference, 0.45; 95% confidence interval, 0.01-0.90; P = 0.04). In biomarker-negative exacerbations, treatment failures occurred in 15% given prednisolone and 2% of those given placebo (P = 0.04).
conclusionsThe peripheral blood eosinophil count is a promising biomarker to direct corticosteroid therapy during COPD exacerbations, but larger studies are required.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.