Observational studyLung2026
Optimizing Inhaled Corticosteroid Prescribing in COPD: Evaluating the Impact of Eosinophil Testing on Clinical Outcomes.
Observational study in Lung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Who cites it
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeInhaled corticosteroids (ICS) are recommended for select patients with chronic obstructive pulmonary disease (COPD) based on exacerbation history and blood eosinophil counts. Prior studies suggest that ICS are frequently prescribed outside of guideline-based criteria, and eosinophil testing is inconsistently performed in clinical practice. This study evaluated adherence to Global Initiative for Chronic Obstructive Lung Disease (GOLD) eosinophil criteria for ICS prescribing and associated clinical outcomes.
methodsThis retrospective observational cohort study included adults with COPD receiving care within Cleveland Clinic outpatient practices in Ohio who were newly initiated on an ICS-containing regimen between January 1, 2021, and July 31, 2023. Patients were classified based on whether ICS prescribing aligned with GOLD eosinophil criteria. Outcomes included adherence to GOLD eosinophil recommendations for ICS use, pneumonia incidence, ICS de-escalation, and predictors of prescribing outside guideline-based criteria.
resultsA total of 688 patients were included. Most patients received ICS outside of GOLD eosinophil criteria (589/688, 86%). Baseline eosinophil testing was performed in 102 patients (15%). Pneumonia incidence was similar among patients prescribed ICS outside versus within guideline-based criteria (15% vs. 16%, p = 0.686). ICS de-escalation was uncommon overall (7%) and occurred at similar rates between groups. A history of prior exacerbations was associated with prescribing within guideline-based indications.
conclusionICS prescribing frequently occurred outside of GOLD eosinophil criteria, with limited utilization of eosinophil testing in clinical practice. Clinical outcomes were similar regardless of guideline alignment, and ICS de-escalation was infrequent. These findings highlight opportunities to improve integration of eosinophil-guided decision-making into COPD management.
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