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The journal of allergy and clinical immunology. In practice · 2025

Adherence to Inhaled Corticosteroids and Clinical Outcomes Following a Year of Tezepelumab Therapy for Severe Asthma.

СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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d'Ancona Grainne, Haris Faizan, Gates Jessica, Stewart-Kelcher Niall, Green Linda, Lam Jodie, Fernandes Mariana, Thomson Louise, Roxas Cris, Yang Zijing, Dhariwal Jaideep, Nanzer Alexandra M, Jackson David J

Аннотация

BACKGROUND: High-dose ICS are associated with adverse effects. Reductions in ICS use during treatment with anti-IL-5/5R therapies can lead to reduced clinical effectiveness in some patients.

OBJECTIVE: This study explored whether the broader anti-type 2 (T2) effects of the anti-thymic stromal lymphopoietin therapy tezepelumab permitted a reduction in ICS use without deleterious clinical consequences.

METHODS: We calculated adherence to ICS/LABA (long-acting β2-agonist) in the 12 months before and 12 months after commencing tezepelumab for severe asthma using the medication possession ratio methodology and classified results as poor (<0.5), suboptimal (0.51-0.74), or good (≥0.75). We compared clinical outcomes including the exacerbation rate, Asthma Control Questionnaire six-question version score, FEV1, and the ability to achieve clinical remission, as well as T2 biomarker levels at 1 year across ICS adherence subgroups.

RESULTS: A total of 152 adults with severe asthma who commenced tezepelumab were included. At the end of 12 months' treatment, there was a significant reduction in the median medication possession ratio from 1.0 (0.83-1.08) at baseline to 0.83 (0.58-1; p = .009). The ICS adherence was good in 69.1%, suboptimal in 12.5%, and poor in 18.4% of patients. At 1 year, improvements in all clinical outcome measures as well as rates of biological remission were similar across ICS adherence groups (all P > .05).

CONCLUSIONS: A fall in ICS adherence after initiation of tezepelumab for severe asthma was not associated with evidence of reduced clinical effectiveness of tezepelumab, including the ability to achieve remission. Similar rates of biological remission further suggest that the broad anti-T2 effect of anti-thymic stromal lymphopoietin may be sufficient to permit a safe reduction in ICS exposure.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты