Takashi Hajiro and Koichi Nishimura*
In clinical practice with patients with chronic obstructive disease (COPD), clinicians should consider patients
symptoms and health status, or quality of life, which are evaluated with patient-reported outcomes (PROs).
Combination bronchodilators proved to be more effective about PROs than monotherapy. Inhaled corticosteroid
(ICS) is associated with risk of pneumonia in COPD patients. Adding ICS to combination bronchodilators, so-called
triple therapy could be effective on dyspnea and health status in patients with elevated blood eosinophil counts.
Therefore, clinicians are advised to assess and re-assess COPD patients in order to get benefits of pharmacological
therapy and reduce risks of adverse events while referring to eosinophil counts.
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