TY -的T1 -坚持吸入糖皮质激素和临床结果在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吸入类皮质激素(ICS)在大多数哮喘患者中实现疾病控制，尽管依从规定的ICS往往较差。患有严重嗜酸粒细胞性哮喘(SEA)的患者可能需要口服皮质类固醇(OCS)和/或生物制剂(如mepolizumab)进行治疗。目前还不清楚ICS依从性是否改变或改变临床对生物治疗的反应。方法我们对完成1年mepolizumab治疗的ocs依赖性SEA患者的ICS依从性和临床结果进行了研究。计算ICS药物持有比例(MPR;在生物启动前一年和生物启动后一年，按处方发放的ICS剂量/预期数量)。良好的依从性被定义为MPR>0.75，中等:0.74-0.51，差:<0.5。我们检查了12个月的生物治疗后的结果，包括OCS减少和年化恶化率(AER)，按坚持使用美泊利珠单抗的ICS进行分层。结果109例启动mepolizumab的患者，91例完成了12个月的治疗被纳入最终分析。在接受美波利珠单抗治疗时，68%的患者依从性良好，16(18%)患者依从性差。 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 -