COPD-related precision medicine research helps hospitals reduce 30-day readmission rates and improve patient outcomes
Hospitals may soon have new precision medicine treatments for patients with chronic obstructive pulmonary disease (COPD). Research out of Switzerland may offer hospitals a way to personalize inhaled corticosteroid treatments for COPD patients and improve outcomes.
With 30-day readmission rates for COPD over 22%, COPD is difficult to manage. European hospitals incur significant expenses, according to a study published in ERJ Open Research, a publication of the European Respiratory Society.
Research conducted at the University of Zurich (UZH) studied how to tailor a common COPD treatment based on traits specific to each patient. Inhaled corticosteroids are a steroid treatment administered directly into the lungs of COPD patients. This inhaled treatment suppresses inflammation in the airways, lowering the risk of exacerbations over the long term.
While inhaled corticosteroids have clinical benefits, they also have several potential clinical complications, including:
- Severe pneumonia
- Oral infections
- Voice changes
These complications, according to the UZH scientists, can outweigh the potential benefits of inhaled corticosteroids in COPD patients, leading to poorer outcomes than would have occurred without the therapy.
Published in The Lancet, titled, “Personalising Add-On Treatment with Inhaled Corticosteroids in Patients with Chronic Obstructive Pulmonary Disease: A Benefit–Harm Modelling Study,” the UZH study found several key factors that should be considered for each patient when determining if inhaled corticosteroid therapy should be used and when planning what dose of the corticosteroids is best for a specific patient.
“Our results show that three key factors influence the balance of treatment benefits and side effects of adding different doses of inhaled corticosteroids”, said Henock Yebyo, PhD (above), the study’s first author in a UZH press release. “[They are] the risk of exacerbation, the amount of certain blood cells, and the patient’s age.” Yebyo is a postdoctoral fellow at the Epidemiology, Biostatistics, and Prevention Institute at the University of Zurich. (Photo: University of Zurich)
Another important finding of the study is that patients who had a two-year exacerbation risk of less than 32% are not likely to have any benefits from using low to moderate doses of inhaled corticosteroids. The study also indicated that patients over the age of 80 were less likely to benefit from inhaled corticosteroids, while patients who had elevated levels of eosinophils, a type of immune cell associated with inflammation, were more likely to benefit.
“Our results may not necessarily lead to less use of inhaled corticosteroids,” Yebyo explained, “but [it] helps to minimize over- and underuse by tailoring treatment according to dose and patient characteristics.”
Personalized COPD Treatments Improve Outcomes
A recent advance in COPD precision medicine was the establishment of the Johns Hopkins Precision Medicine Center of Excellence for Chronic Obstructive Pulmonary Disease. While this initiative was only founded at the end of 2019 and is still in its early days, it demonstrates the interest that is beginning to be shown in applying precision medicine to this common lung condition.
The Johns Hopkins Precision Medicine Center of Excellence for COPD has three main goals, including:
- Improving outcomes
- Identifying COPD subgroups
- Building comprehensive research programs
Johns Hopkins currently has multiple clinical research programs underway to help improve the personalization of COPD care, ultimately improving the outcomes that patients experience.
Precision medicine research for COPD is in its early days, but studies such as the research recently published by UZH demonstrate the benefits that this research will ultimately provide for hospitals.
“Our study may serve as an example of how the complexity of the benefit-harm balance can be approached in a systematic way so that treatment guidelines can provide specific and useful recommendations on how to personalize treatments,” said UZH professor Milo Puhan, PhD, director of the Epidemiology, Biostatistics, and Prevention Institute in the UZH press release.
Hospital leaders wanting to reduce 30-day readmission rates for COPD patients will benefit from staying abreast of COPD-related precision medicine research like the UZH study. By being aware of how the field of precision medicine is beginning to offer COPD treatment improvements, hospitals will be better able to serve the many patients with this chronic disease.
—Caleb Williams
Related Information:
Predicting and Preventing Hospital Readmission for Exacerbations of COPD