抽象
介绍吸入糖皮质激素(ICS)实现在大多数哮喘患者的病情控制后,虽然遵守规定的ICS往往较差。患有严重哮喘嗜酸性可能需要具有口服皮质类固醇(OCS)和/或生物剂如美泊利单抗的治疗。它是未知的,如果ICS坚持改变,或者变造的临床反应,生物疗法。
方法We examined ICS adherence and clinical outcomes in OCS-dependent severe eosinophilic asthma patients who completed 1 year of mepolizumab therapy. The ICS medicines possession ratio (MPR) was calculated (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.
结果Out of 109 patients commencing mepolizumab, 91 who had completed 12 months of treatment were included in the final analysis. While 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 during mepolizumab treatment (0.82±0.32; p=0.78). Patients with good adherence had greater reductions in OCS dose (median (interquartile range) OCS reduction 100 (74–100)%与60(27-100)%;P = 0.031)和加重(AER变化-2.1±3.1与0.3±2.5;P = 0.011)比那些具有依从性差。良好粘附ICS预测停止维护OCS(调整OR 3.19,95%CI 1.02-9.94; P = 0.045)的可能性。
结论ICS不依是在美泊利单抗接收严重嗜酸性哮喘患者中常见,并且与OCS要求和AER较小减少相关联。
抽象
坚持ICS可怜的是在接受美泊利单抗重度哮喘患者中常见,并会增加口服糖皮质激素暴露和恶化风险http://bit.ly/2v9hdAi
脚注
利益冲突:G. D'安科纳报告从GSK个人费用,在研究进行期间;阿斯利康补助和个人的费用,从纳普制药,基耶西制药,勃林格殷格翰公司和梯瓦制药,外提交作品的个人费用。
利益冲突:J.卡瓦纳有没有透露。
利益冲突:C.罗哈斯有没有透露。
利益冲突:L.格林有没有透露。
利益冲突:M.费尔南德斯有没有透露。
利益冲突:L.汤姆逊有没有透露。
利益冲突:J.达里瓦尔有没有透露。
利益冲突:上午Nanzer有没有透露。
利益冲突:D.J.杰克逊报告赠款和个人费用从阿斯利康公司,提交作品之外。
利益冲突:B.D.肯特报告从GSK个人费用,在研究进行期间;个人费用由阿斯利康制药纳普基耶西和制药,勃林格殷格翰公司和梯瓦制药,外提交作品的非金融支持。
- 收到2019年11月22日。
- 公认2020年2月3日。
- 版权所有©ERS 2020