杂志文章d'Ancona, Grainne %A Kavanagh, Joanne %A Roxas, Cris %A Green, Linda %A Fernandes, Mariana %A Thomson, Louise %A Dhariwal, Jaideep %A Nanzer, Alexandra M. %A Jackson, David J. %A Kent，布莱恩·D·% T坚持吸入糖皮质激素和临床结果mepolizumab治疗严重哮喘% D J 2020% R 10.1183/13993003.02259 -2019%欧洲呼吸杂志% P 1902259 % V 55% N 5% X引入吸入激素(ICS)实现疾病控制大多数哮喘病人,尽管坚持规定ICS往往是穷人。严重嗜酸性粒细胞性哮喘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ocs依赖性严重嗜酸性哮喘患者的ICS依从性和临床结果。计算了生物制剂推出前一年及推出后一年的综合药物持有比率(按处方发出的综合药物剂量/预期数量)。良好依从性定义为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。结果在109名开始mepolizumab治疗的患者中，91名完成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。队列中ICS的使用在前(MPR 0.81±0.32)和mepolizumab治疗期间(0.82±0.32)相似; p=0.78). Patients with good adherence had greater reductions in OCS dose (median (interquartile range) OCS reduction 100 (74–100)% versus 60 (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 nonadherence is common in severe eosinophilic asthma patients receiving mepolizumab, and is associated with a lesser reduction in OCS requirements and AER.Poor adherence to ICS is common in severe asthma patients receiving mepolizumab, and is associated with increased oral corticosteroid exposure and exacerbation risk http://bit.ly/2v9hdAi %U //www.qdcxjkg.com/content/erj/55/5/1902259.full.pdf