TY -的T1 -坚持皮质类固醇和临床结果在Mepolizumab治疗严重哮喘JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.02259 -2019欧元SP - 1902259 AU d 'Ancona, Grainne AU -卡文纳,乔安妮AU -罗哈斯,短剑盟——绿色,琳达AU -费尔南德斯,马里亚纳非盟-汤姆森,路易丝盟——Dhariwal Jaideep AU - Nanzer,亚历山德拉m . AU -杰克逊,David J . AU -肯特摘要N2 -引入吸入糖皮质激素(ICS)在大多数哮喘患者中实现了疾病控制，尽管依从性通常很差。严重嗜酸性粒细胞性哮喘(SEA)患者可能需要口服糖皮质激素(OCS)和/或生物制剂，如美波利单抗。目前尚不清楚ICS的依从性是否改变或改变了对生物疗法的临床反应。方法我们研究了完成1年mepolizumab治疗的依赖ocs的SEA患者ICS的依从性和临床结果。计算了ICS药物持有率(MPR;开始使用生物制剂前一年及后一年按处方开出的药物剂量/预期剂量)。良好粘附性定义为MPR>0.75，中间:0.74-0.51，差:<0.5。我们检查了12个月生物治疗后的结果，包括OCS减少和年化恶化率(AER)，并根据服用mepolizumab的ICS进行分层。结果109例开始使用mepolizumab的患者中，91例完成12个月治疗的患者被纳入最终分析。接受mepolizumab治疗时，68%的患者对ICS的依从性良好，16人(18%)对ICS的依从性较差。 ICS use within the cohort remained similar before (MPR 0.81±0.32) and on mepolizumab (0.82±0.32;p=0.78). Patients with good adherence had greater reductions in OCS dose (median percentage OCS reduction 100(IQR 74–100) versus 60(IQR 27–100);p=0.031) and exacerbations (AER change −2.1±3.1 versus 0.3±2.5;p=0.011) than those with poor adherence. Good ICS adherence predicted the likelihood of stopping maintenance OCS (adjusted OR 3.19;95%CI 1.02–9.94;p=0.045).Conclusion ICS non-adherence is common in SEA patients receiving mepolizumab, and is associated with a lesser reduction in OCS requirements and AER.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Ms. D'Ancona reports personal fees from GSK, during the conduct of the study; grants and personal fees from Astra-Zeneca, personal fees from Napp Pharmaceuticals, personal fees from Chiesi Pharmaceuticals, personal fees from Boehringer-Ingelheim, personal fees from Teva Pharmacueticals, outside the submitted work.Conflict of interest: Dr. Kavanagh has nothing to disclose.Conflict of interest: Ms. Roxas has nothing to disclose.Conflict of interest: Ms. Green has nothing to disclose.Conflict of interest: Ms. Fernandes has nothing to disclose.Conflict of interest: Ms. Thomson has nothing to disclose.Conflict of interest: Dr. Dhariwal has nothing to disclose.Conflict of interest: Dr. Nanzer has nothing to disclose.Conflict of interest: Dr. Jackson reports grants and personal fees from Astra-Zeneca, outside the submitted work.Conflict of interest: Dr. Kent reports personal fees from GSK, during the conduct of the study; personal fees from Astra-Zeneca, personal fees from Napp Pharmaceuticals, personal fees from Chiesi Pharmaceuticals, non-financial support from Boehringer-Ingelheim, non-financial support from Teva Pharmacueticals, outside the submitted work. ER -