In Asthma, Blood Eosinophil Counts Remain Lower After Systemic Corticosteroid Discontinuation

Blood eosinophil counts decrease after beginning systemic corticosteroid therapy. And according to a new study, those counts do not return to index levels in patients with asthma even several weeks after they have discontinued the therapy. 

To reach this conclusion, the researchers retrospectively studied data from the Reliant Medical Group electronic medical records between January 2011 and December 2015. Using these records, the researchers identified patients who were aged at least 12 years and who had at least 1 prescription for systemic corticosteroid (average initial prescription of 35 mg per day), at least 1 asthma diagnosis, and at least 1 eosinophil count in each 12-month pre- and post-index periods. In all, the researchers identified 1198 participants.

IF YOU LIKE THIS, READ MORE...

Asthma Risk Is Linked to Age at First Respiratory Syncytial Virus Infection

5 Questions About Gut Regulation of Airway Disease

At index visit, 642 of the participants had a blood eosinophil count of 150 cells/µL or greater. After 1 month of the systemic corticosteroid treatment, these participants experienced a mean decrease in blood eosinophil count of 112 cells/µL from index. 

Participants who had a blood eosinophil count of 300 cells/µL or greater and 400 cells/µL or greater had an even larger decrease in mean eosinophil counts from index to month 1.

After discontinuing their systemic corticosteroid treatment within 7 days after the index date, 21% of the participants who had 150 cells/µL or greater at index had an eosinophil count less than 150 cells/µL a month post-index. 

Further, among patients who had 150 cells/µL or greater at index, 26% of those who discontinued treatment within 14 days of their index date and 25% of those who discontinued treatment within 21 days of their index date also had an eosinophil count of less than 150 cells/µL a month post-index.

“The time frame of systemic corticosteroid discontinuation is an important consideration when identifying patients with eosinophilic asthma,” the researchers concluded.

—Colleen Murphy

Reference:

Ortega H, Llanos JP, Lafeuille MH, et al. Effects of systemic corticosteroids on blood eosinophil counts in asthma: real-world data. J Asthma. 2019;56(8):808-815. doi:10.1080/02770903.2018.1502301.