Eosinophils Take the Wheel in Steering Steroid Therapy for COPD Exacerbations

Authors:
Hope Shrader Sherman, PharmD
Maricar Conson, PharmD, BCACP

Reviewers:
Jean Moon, PharmD, BCACP
Mark Pulver, PharmD
Lori Wilken, PharmD, BCACP

Citation:
Ramakrishnan S, Jeffers H, Langford-Wiley B, et al. Blood eosinophil-guided oral prednisolone for COPD exacerbations in primary care in the UK (STARR2): a non-inferiority, multicentre, double-blind, placebo-controlled, randomised controlled trial. Lancet Respir Med. 2024;12:67-77.

The Problem

Emerging data suggests we may have been overzealous with systemic corticosteroid prescribing and that allowing patients to self-manage their exacerbations with steroid rescue therapy may be harmful. However, we can now identify a subgroup of COPD patients who might benefit from systemic corticosteroids to treat their exacerbation.