RT Journal Article SR Electronic T1 12-year adherence to inhaled corticosteroids in adult-onset asthma JF ERJ Open Research JO erjor FD European Respiratory Society SP 00324-2019 DO 10.1183/23120541.00324-2019 VO 6 IS 1 A1 Iida Vähätalo A1 Pinja Ilmarinen A1 Leena E. Tuomisto A1 Minna Tommola A1 Onni Niemelä A1 Lauri Lehtimäki A1 Pentti Nieminen A1 Hannu Kankaanranta YR 2020 UL http://openres.ersjournals.com/content/6/1/00324-2019.abstract AB Adherence to inhaled corticosteroids (ICS) has been suggested to be poor but long-term follow-ups are lacking. The objective of the present study was to assess adherence to ICS treatment in patients with adult-onset asthma during 12-year follow-up.A total of 181 patients with clinically confirmed, new-onset adult asthma were followed for 12 years as part of the Seinäjoki Adult Asthma Study. Adherence to ICS was assessed individually as the percentage of true dispensed ICS in micrograms per true prescribed daily ICS in micrograms over 12 years.Mean 12-year adherence to ICS was 69% (mean±sd dispensed 2.5±1.8 g and prescribed 3.6±1.5 g budesonide equivalent per patient for 12 years), annual adherence varying between 81% (year 1) and 67% (year 12). Patients with good 12-year adherence (≥80%) used oral corticosteroids more often, and had add-on drugs in use and asthma-related visits to healthcare more often. In addition, they showed less reversibility in forced expiratory volume in 1 s and had higher peripheral blood neutrophil counts. However, lung function decline was steeper in patients with poorer adherence (<80%) and this association remained in multiple linear regression analysis. No difference was found in symptom scores, blood eosinophil counts, exhaled nitric oxide or immunoglobulin E between the patients with different levels of adherence.In patients with adult-onset asthma, adherence to ICS was moderate. Poorer adherence (<80%) to ICS was associated with more rapid decline in lung function but was not associated to symptoms or markers of inflammatory endotypes.Mean long-term adherence to ICS treatment is 69% in patients with confirmed adult-onset asthma. While good ICS adherence (≥80%) is associated with features of more severe asthma, poorer adherence (<80%) predicts more rapid lung function decline. http://bit.ly/37mvh74