A2 Refereed review article in a scientific journal
The Burden of COPD with Type 2 Inflammation in North-West Continental Europe
Authors: Sandelowsky, Hanna; Løkke, Anders; Kocks, Janwillem; Grøttum, Helle; Bakke, Per; Vasankari, Tuula
Publisher: Dove Medical Press
Publication year: 2025
Journal: International Journal of Chronic Obstructive Pulmonary Disease
Journal name in source: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 20
First page : 2767
Last page: 2785
ISSN: 1176-9106
eISSN: 1178-2005
DOI: https://doi.org/10.2147/COPD.S523371
Web address : https://doi.org/10.2147/copd.s523371
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/499843945
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.