ERS 2022
If the number of eosinophils in the blood is used as a decision-making aid in patients with COPD exacerbations, the use of systemic steroids can be reduced without the patients suffering any clinical disadvantages as a result. This is shown by the results of the STARR2 study presented as part of the ERS 2022.
Reducing exposure to systemic steroids is an important goal in the treatment of respiratory diseases in general. In the case of COPD, their use is largely reduced to the management of severe exacerbations, in which context the use of systemic steroids is standard. This poses risks for patients, as recent study data show that the cumulative dose of oral corticosteroids is associated with mortality in COPD patients. Even if these are only used for a short time, the risk of sepsis, deep vein thrombosis and fractures increases.1
This raises the question of whether there is no alternative to the use of oral steroids in COPD exacerbations and whether all patients actually benefit equally from this medication. Mona Bafadhel of King’s College London, who also points out that fewer than 1,000 patients in this indication have received treatment with oral corticosteroids in randomised, controlled clinical trials to date.
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