RT期刊文章SR电子T1坚持吸入糖皮质激素和临床结果Mepolizumab治疗严重哮喘摩根富林明欧洲呼吸杂志乔和J FD欧元欧洲呼吸学会SP 1902259 10.1183/13993003.02259 -2019 A1 d 'Ancona Grainne A1 Kavanagh,乔安妮A1罗哈斯,短剑A1绿色,琳达A1费尔南德斯,马里亚纳A1汤森,路易丝A1 Dhari188bet官网地址wal, Jaideep A1 Nanzer,亚历山德拉·m·杰克逊A1, David J . A1肯特,摘要吸入类皮质激素(ICS)在大多数哮喘患者中实现疾病控制，尽管依从规定的ICS通常效果不佳。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)。MPR>0.75为良好依从性，中位:0.74-0.51，差位:<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.