{
  "abstract": "Inhaled corticosteroids (ICSs) benefit patients with chronic obstructive pulmonary disease at high risk of exacerbations with raised blood eosinophil count (BEC). Emerging evidence suggests current smokers show a reduced response to ICS. This post-hoc analysis of the FLAME trial explored the impact of smoking status on the efficacy of long-acting beta-2 agonist (LABA)+ICS versus LABA+long-acting muscarinic antagonist (LAMA) for preventing exacerbations. Our findings indicate that LABA+LAMA is superior to LABA+ICS in preventing moderate to severe exacerbations in current smokers and inferior in ex-smokers with BEC ≥200 cells/µL. Smoking status significantly modifies ICS treatment effects on exacerbation outcomes, suggesting reduced ICS efficacy in current smokers, regardless of BEC.",
  "authors": [
    {
      "affiliations": [
        "Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK",
        "North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Alexander G Mathioudakis"
    },
    {
      "affiliations": [
        "Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK"
      ],
      "name": "Andrew Higham"
    },
    {
      "affiliations": [
        "Research and Innovation, Manchester University NHS Foundation Trust, Manchester, UK",
        "Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, The University of Manchester, Manchester, UK"
      ],
      "name": "Sebastian Bate"
    },
    {
      "affiliations": [
        "Department of Endocrinology, The Christie Hospital NHS Trust, Manchester, Manchester, UK",
        "Division of Diabetes, Endocrinology and Gastroenterology, The University of Manchester, Manchester, UK"
      ],
      "name": "Victoria Chatzimavridou-Grigoriadou"
    },
    {
      "affiliations": [
        "Section of Respiratory Medicine, Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Kobenhavn, Denmark",
        "Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Kobenhavn, Region Hovedstaden, Denmark"
      ],
      "name": "Pradeesh Sivapalan"
    },
    {
      "affiliations": [
        "Section of Respiratory Medicine, Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Kobenhavn, Denmark",
        "Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Region Hovedstaden, Denmark",
        "Department of Medicine, Copenhagen University Hospital, Kobenhavn, Denmark"
      ],
      "name": "Jens-Ulrik Stæhr Jensen"
    },
    {
      "affiliations": [
        "Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK",
        "Acute Intensive Care Unit, Wythenshawe Hospital, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Tim Felton"
    },
    {
      "affiliations": [
        "Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK",
        "Section of Respiratory Medicine, Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Kobenhavn, Denmark"
      ],
      "name": "Jørgen Vestbo"
    },
    {
      "affiliations": [
        "Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK",
        "North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, UK",
        "Medicines Evaluation Unit, Wythenshawe, Greater Manchester, UK"
      ],
      "name": "Dave Singh"
    }
  ],
  "title": "Reduced treatment response to inhaled corticosteroids in current smokers with COPD, regardless of blood eosinophil count: insights from the FLAME trial",
  "uid": "f1127065-d694-5d88-b193-740b5d19222b"
}