A2 Refereed review article in a scientific journal

The Burden of COPD with Type 2 Inflammation in North-West Continental Europe




AuthorsSandelowsky, Hanna; Løkke, Anders; Kocks, Janwillem; Grøttum, Helle; Bakke, Per; Vasankari, Tuula

PublisherDove Medical Press

Publication year2025

JournalInternational Journal of Chronic Obstructive Pulmonary Disease

Journal name in sourceInternational Journal of Chronic Obstructive Pulmonary Disease

Volume20

First page 2767

Last page2785

ISSN1176-9106

eISSN1178-2005

DOIhttps://doi.org/10.2147/COPD.S523371

Web address https://doi.org/10.2147/copd.s523371

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/499843945


Abstract

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease that places a huge burden on patients, health systems and societies. Yet despite this, COPD is often neglected: it is frequently underdiagnosed or misdiagnosed, and since tobacco exposure is a primary risk factor for its development, patients are often stigmatized and marginalized because they are perceived as having a “self-inflicted” disease. COPD is primarily understood to be a functional disorder with chronic airway obstruction, yet there are several underlying inflammatory pathways. For most patients with COPD, type 1 (neutrophilic) inflammation is the main such pathway; however, a considerable proportion has type 2 inflammation (associated with elevated eosinophil numbers). COPD with type 2 inflammation may represent a distinct COPD phenotype and a “treatable trait”. In fact, the response to inhaled corticosteroids (ICS) is linked to blood eosinophil levels: treatment effects begin to increase in patients with blood eosinophil counts ≥ 100 cells/μL, and most treatment guidelines recommend considering ICS for patients with blood eosinophil counts ≥ 300 cells/μL. Data on the burden of COPD with type 2 inflammation are limited. COPD with type 2 inflammation may associate with poor outcomes, and higher blood eosinophil counts positively associate with an increased risk of moderate or severe exacerbations. Exacerbations are among the most dangerous aspects of COPD, accelerating disease progression and increasing morbidity and mortality. This review explores the burden of COPD – specifically eosinophilic COPD – across north-western Europe. It aims to provide information relevant to patients, clinicians and policymakers, educating them about type 2 inflammation and its contribution to the disease burden. It has been informed by multiple stakeholders, including patients, and offers practical and achievable recommendations for enhancing the care of all patients with COPD through a better understanding of COPD with type 2 inflammation.


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Funding information in the publication
This project received funding from Sanofi. The funder paid honoraria to participants for their meeting attendance, but not for their manuscript authoring. Sanofi was not involved in the analysis, interpretation of data, the writing of this article or the decision to submit it for publication. Facilitation of interviews and round table discussions plus medical writing support was provided by Keena McKillen (CCN17 Ltd, Cambridge, UK) with additional writing and editorial review provided by Maria Dalby (Norse Horse Ltd, Ely, UK) and Alice Kirk (Kirk MedComms Ltd, Cambridge, UK): these specific services were funded by Sanofi.


Last updated on 2025-19-09 at 10:03