Monitoring COPD patients systemic and bronchial eosinophilic inflammation in a 2-year follow-up: few concerns

Monitoring COPD patients: systemic and bronchial eosinophilic inflammation in a 2-year follow-up" by Pignatti et al. provides valuable insights about changes in blood and sputum eosinophils in mild to moderate COPD patients and treatment outcomes. However, concerns arise regarding the accuracy of diagnosis of COPD in subjects with a significant bronchodilator response despite FEV1/FVC ≤ 70%. Although statistically significant differences in FEV1/FVC were observed, the clinical relevance needs scrutiny. Despite a clinically meaningful difference in FEV1 between ICS-treated and untreated patients, the lack of statistical significance raises questions. Addressing these concerns will strengthen the study's reliability and interpretation.