A systematic review of blood eosinophils and continued treatment with inhaled corticosteroids in patients with COPD

Inhaled corticosteroid (ICS) in patients with chronic obstructive pulmonary disease (COPD) has been debated for 20 years. In our systematic literature review and meta-analysis, we addressed the following: Should patients with COPD and a blood eosinophil count (EOS) of, respectively, a)?<?150?cells/?l, b) 150–300?cells/?l, and c)?>?300?cells/?l continue treatment with ICS? Protocol registered in PROSPERO (CRD42020178110) and funded by the Danish Health Authority.We searched Medline, Embase, CINAHL and Cochrane Central on 22nd July 2020 for randomized controlled trials (RCT) of ICS treatment in patients with COPD (?40 years, no current asthma), which analyzed outcomes by EOS count and where >50% of patients used ICS prior.