Journal club

Follow the stars: blood eosinophil-directed treatment of COPD exacerbations Oral corticosteroids (OCS) have been the acute treatment for COPD exacerbations for decades based on small trials primarily conducted in inpatients. But OCS have devastating long-term risks that increase cumulatively with dose. Ramakrishnan and colleagues (Lancet Respiratory Medicine 2023, DOI: 10.1016 /S2213-2600(23)00298-9) tested whether blood eosinophil-directed prednisolone treatment (BET) was non-inferior to standard treatment with prednisolone (ST) in this multicentre, double-blind, randomised, placebo-controlled trial (STARR2). In 14 UK-based general practices, 144 COPD exacerbations from 93 participants were randomised equally to BET or ST. All patients also received oral antibiotics. The primary outcome was the rate of treatment failure (re-treatment with antibiotics or steroids, hospitalisation for any cause, or death, assessed at 30 days). An upper margin of 1.105 for the 95% CI was defined as the non-inferiority margin to capture 75% of the benefit obtained from standard care. There were 14...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Thorax Journal club Source Type: research