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欧元六世- 55 - 5 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,尽管对处方药物的依从性往往很差。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。未知的如果ICS依从性变化,或改变的临床反应,生物治疗。方法我们研究了完成1年mepolizumab治疗的ocs依赖性严重嗜酸性粒细胞性哮喘患者的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)。良好的粘附性定义为MPR >0.75,中间0.74-0.51和差的<0.5。我们检查的结果经过12个月的生物疗法,包括减少口服避孕药和折合成年率的恶化(AER),分层在mepolizumab坚持ICS。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 ER -