Comparing the Efficacy of Inhaled Corticosteroid (ICS) Treatment in COPD Patients Based on Blood Eosinophilia: A Clinical Trial Study

Background: Inhaled corticosteroids (ICSs) have been widely used in the maintenance therapy of chronic obstructive pulmonary disease (COPD). Eosinophilic airway inflammation is a recognized inflammatory endotype in COPD. Nevertheless, the benefits and risks of ICS treatment remain controversial. Objectives: Therefore, in this study, we determine the frequency of eosinophilia in COPD patients and compare the effects of ICSs in patients with and without eosinophilia referring to the lung clinics of Zahedan University of Medical Sciences. Methods: In this study, 58 COPD patients were examined. Peripheral blood smears (PBS) were collected from all patients, and they were randomly divided into 2 groups. First, a 6-minute walking test (6MWT) was performed on all patients. Thereafter, two groups of patients received standard treatment with the Symbicort spray for 3 months. They were followed for this period, and the 6MWT was performed again at the end of the 3 months. Results: The mean results of the 6MWT test before and after intervention in the eosinophilia-positive group were 164.02 meters and 192.11 meters, respectively. Therefore, there was a significant difference in patient activity levels before and after ICSs (P = 0.017). In the eosinophilia-negative group, there was a significant difference in patient activity levels based on the 6MWT test before and after taking ICSs (P < 0.001). However, there was no difference in activity levels between the two groups before and after the intervention (P = 0.68 and P = 0.36). Conclusions: Our finding showed that treatment with inhaled β2-agonists plus corticosteroids did not affect the response to this treatment in subjects' groups with and without eosinophilia compared to the pre-treatment conditions.