％0期刊论文％A D'安科纳，Gráinne％A卡瓦纳，乔安妮％A罗哈斯，克里斯％绿色，琳达％A费尔南德斯，马里亚纳％A汤姆森，路易丝％A达里瓦尔，Jaideep％A Nanzer，珊M.％A杰克逊，大卫J.％A肯特，布莱恩D.％T坚持吸入糖皮质激素和临床结果在美泊利单抗治疗重症哮喘％d 2020％R 10.1183 / 13993003.02259-2019％Ĵ欧洲呼吸杂志％P 1902259％X介绍吸入糖皮质激素（ICS）实现在大多数哮喘患者的疾病控制，尽管遵守规定的ICS往往较差。患有严重哮喘嗜酸性（SEA）可能需要与口服皮质类固醇（OCS）和/或生物剂如美泊利单抗的治疗。It is unknown if ICS adherence changes on, or alters clinical response to, biologic therapy.Methods We examined ICS adherence and clinical outcomes in OCS-dependent SEA patients who completed 1 year of mepolizumab therapy. The ICS Medicines Possession Ratio was calculated (MPR; the number of doses of ICS issued on prescription/expected number) for the year before and the year after biologic initiation. Good adherence was defined as MPR>0.75, intermediate: 0.74–0.51 and poor: <0.5. We examined outcomes after 12 months of biologic therapy, including OCS reduction and annualised exacerbation rate (AER), stratified by adherence to ICS on mepolizumab.Results Of 109 patients commencing mepolizumab, 91 who had completed 12 months of treatment were included in the final analysis. Whilst receiving mepolizumab, 68% had good ICS adherence, with 16(18%) having poor ICS adherence. 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. %U //www.qdcxjkg.com/content/erj/early/2020/02/14/13993003.02259-2019.full.pdf