Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics
Abstract Background Systemic glucocorticoids are associated with significant side effects, however, are essential in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD). Biologic therapies in COPD with type 2 (T2) inflammation have shown benefit in reducing exacerbat...
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BMC
2025-07-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-025-03809-4 |
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| author | Truong-An A. Ho Stephen Dachert Anugya Mittal Gerard J. Criner |
| author_facet | Truong-An A. Ho Stephen Dachert Anugya Mittal Gerard J. Criner |
| author_sort | Truong-An A. Ho |
| collection | DOAJ |
| description | Abstract Background Systemic glucocorticoids are associated with significant side effects, however, are essential in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD). Biologic therapies in COPD with type 2 (T2) inflammation have shown benefit in reducing exacerbations, but their impact on glucocorticoid utilization remains unclear. We aim to examine if use of biologics in COPD patients reduces glucocorticoid burden. Methods A retrospective review of the electronic medical record (2016–2023) was performed. Patients with COPD that were treated with biologics were included. Data collected included demographics, baseline comorbidities, eosinophil count, pulmonary function testing and dispense reports for glucocorticoids. The primary outcomes were a change in the number of glucocorticoid dispenses and total cumulative systemic glucocorticoid dosage, in the year prior and post initiation of therapy. Results 56 patients (mean age 71 ± 8.5) were included in the study. 55% had coronary artery disease, 25% had heart failure, 71% had hypertension, 14% had stroke and 30% had diabetes. Biologics significantly reduced annual glucocorticoid dispenses (3.38 ± 2.58 vs. 2.22 ± 2.33, mean reduction 1.16, 95% CI 0.45–1.87, p = 0.002) and cumulative dosage (1073 ± 831 mg vs. 659 ± 723 mg, mean reduction 413.2 mg, 95% CI 180.8–645.6, p = 0.001). There was no strong association between baseline eosinophil count and glucocorticoid utilization. Conclusions In this real-world cohort of COPD patients with T2 inflammation, the addition of biologic therapies was associated with a significant reduction in systemic glucocorticoid usage, both in terms of dispense frequency and overall total dosage of systemic glucocorticoids. This highlights the potential of biologics to reduce glucocorticoid-related adverse effects in COPD patients. |
| format | Article |
| id | doaj-art-cc3228195bf04b1aba81484bc74fe059 |
| institution | DOAJ |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-cc3228195bf04b1aba81484bc74fe0592025-08-20T03:04:10ZengBMCBMC Pulmonary Medicine1471-24662025-07-012511710.1186/s12890-025-03809-4Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologicsTruong-An A. Ho0Stephen Dachert1Anugya Mittal2Gerard J. Criner3Department of Thoracic Medicine and Surgery, Lewis Katz School of MedicineDepartment of Thoracic Medicine and Surgery, Lewis Katz School of MedicineDepartment of Medicine, Temple University HospitalDepartment of Thoracic Medicine and Surgery, Lewis Katz School of MedicineAbstract Background Systemic glucocorticoids are associated with significant side effects, however, are essential in the treatment of acute exacerbations of chronic obstructive pulmonary disease (COPD). Biologic therapies in COPD with type 2 (T2) inflammation have shown benefit in reducing exacerbations, but their impact on glucocorticoid utilization remains unclear. We aim to examine if use of biologics in COPD patients reduces glucocorticoid burden. Methods A retrospective review of the electronic medical record (2016–2023) was performed. Patients with COPD that were treated with biologics were included. Data collected included demographics, baseline comorbidities, eosinophil count, pulmonary function testing and dispense reports for glucocorticoids. The primary outcomes were a change in the number of glucocorticoid dispenses and total cumulative systemic glucocorticoid dosage, in the year prior and post initiation of therapy. Results 56 patients (mean age 71 ± 8.5) were included in the study. 55% had coronary artery disease, 25% had heart failure, 71% had hypertension, 14% had stroke and 30% had diabetes. Biologics significantly reduced annual glucocorticoid dispenses (3.38 ± 2.58 vs. 2.22 ± 2.33, mean reduction 1.16, 95% CI 0.45–1.87, p = 0.002) and cumulative dosage (1073 ± 831 mg vs. 659 ± 723 mg, mean reduction 413.2 mg, 95% CI 180.8–645.6, p = 0.001). There was no strong association between baseline eosinophil count and glucocorticoid utilization. Conclusions In this real-world cohort of COPD patients with T2 inflammation, the addition of biologic therapies was associated with a significant reduction in systemic glucocorticoid usage, both in terms of dispense frequency and overall total dosage of systemic glucocorticoids. This highlights the potential of biologics to reduce glucocorticoid-related adverse effects in COPD patients.https://doi.org/10.1186/s12890-025-03809-4Glucocorticoid sparingBiologic therapyCOPDType 2 inflammationEosinophilia |
| spellingShingle | Truong-An A. Ho Stephen Dachert Anugya Mittal Gerard J. Criner Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics BMC Pulmonary Medicine Glucocorticoid sparing Biologic therapy COPD Type 2 inflammation Eosinophilia |
| title | Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics |
| title_full | Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics |
| title_fullStr | Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics |
| title_full_unstemmed | Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics |
| title_short | Reduction in systemic glucocorticoid utilization among COPD patients with type 2 inflammation treated with biologics |
| title_sort | reduction in systemic glucocorticoid utilization among copd patients with type 2 inflammation treated with biologics |
| topic | Glucocorticoid sparing Biologic therapy COPD Type 2 inflammation Eosinophilia |
| url | https://doi.org/10.1186/s12890-025-03809-4 |
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