RT Journal Article
SR Electronic
T1 The role of adherence to inhaled corticosteroids (ICS) in the relationship between blood eosinophilia and asthma control
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA840
DO 10.1183/13993003.congress-2016.PA840
VO 48
IS suppl 60
A1 Alberto Papi
A1 Dermot Ryan
A1 Joan Soriano
A1 Henry Chrystyn
A1 Leif Bjermer
A1 Roberto Rodríguez-Roisin
A1 Myrna Dolovich
A1 Mark Harris
A1 Bakhtiyor Khalikulov
A1 David Price
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA840.abstract
AB Background: Novel therapies targeting raised eosinophil counts improve asthma control, but the inappropriate use of these treatments in patients with poor adherence to standard therapy is a concern.Aim: To determine if poor adherence to ICS therapy explains poor asthma control in patients with raised blood eosinophils.Methods: Historical, observational, cohort study using clinical practice data of UK patients with asthma, aged ≥18 years, with ≥1 year ICS therapy (GINA steps 3 and 4). Patient records with increased (>0.4x109/L) or normal eosinophil levels (≤0.4x109/L) were analysed by demographic and clinical characteristics, and adherence to ICS. Descriptive statistics were reported as number (%) of patients with exacerbations and with controlled asthma.Results: Patients had a median eosinophil count of 0.5x109/L and mean % predicted peak expiratory flow of 78%. Overall, 1,031 (14%) of 7,195 patients had increased blood eosinophil counts (mean age 60 years [SD 15.8]; 42% male).Of patients with increased blood eosinophil levels, 38% had good adherence to ICS therapy, yet 74% of them remained uncontrolled. Patients with ≥1 exacerbation were more adherent to prescribed therapy than patients with no history of exacerbations (30% vs 16%; p<0.001). A higher proportion of uncontrolled than well controlled patients showed good adherence to treatment (44% vs 27%, p<0.001).Conclusion: Poor adherence to ICS therapy does not explain poor asthma control in patients with increased blood eosinophils. Novel therapies might be considered for patients who do not respond to traditional ICS controller treatment despite good adherence.