%0 Journal Article %A Iida Vähätalo %A Hannu Kankaanranta %A Leena E. Tuomisto %A Onni Niemelä %A Lauri Lehtimäki %A Pinja Ilmarinen %T Long-term adherence to inhaled corticosteroids and asthma control in adult-onset asthma %D 2021 %R 10.1183/23120541.00715-2020 %J ERJ Open Research %P 00715-2020 %X Background In short-term studies poor adherence to inhaled corticosteroids (ICS) has been associated with worse asthma control but the association of long-term adherence and disease control remains unclear.Objective To assess the relationship between 12-year adherence to ICS and asthma control in patients with adult-onset asthma.Methods As part of Seinäjoki Adult Asthma Study (SAAS), 181 patients with clinically confirmed new-onset adult asthma and regular ICS medication were followed for 12 years. Adherence (%) to ICS was assessed individually ((µg dispensed/µg prescribed)x100) during the follow-up. Asthma control was evaluated after 12-years of treatment according to GINA 2010 guideline.Results Asthma was controlled in 31% and not-controlled (partly or uncontrolled) in 69% of the patients. Patients with not-controlled asthma were more often males, older, non-atopic and used higher doses of ICS than those with controlled disease. The mean 12-year adherence to ICS was 63% (sd 38%) in patients with controlled asthma and 76% (sd 40%) in patients with not-controlled disease (p=0.042). Among patients with not-controlled asthma, those with lower 12-year adherence (<80%) had more rapid decline in FEV1 (−47 mL·year−1) compared to patients with better adherence (≥80%) (−40 mL·year−1) (p=0.024). In contrast, this relationship was not seen in patients with controlled asthma.Conclusions In adult-onset asthma, patients with not-controlled disease showed better 12-year adherence to ICS treatment than those with controlled asthma. In not-controlled disease, adherence <80% was also associated with more rapid lung function decline underscoring the importance of early recognition of such patients in routine clinical practice.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. 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 ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Vähätalo has nothing to disclose.Conflict of interest: H. Kankaanranta reports fees for lectures and consulting, costs for attending an international congress, and research grant to his institution from AstraZeneca; fees for consulting from Chiesi Pharma AB; fees for lectures and consulting, and costs for attending an international congress from Boehringer Ingelheim; fees for lectures and consulting from Novartis; fees for lectures from Mundipharma; fees for lectures and consulting, and costs for attending international congress from Orion Pharma; fees for consulting from SanofiGenzyme; and fees for lectures and consulting from GlaxoSmithKline, all outside the submitted work.Conflict of interest: L.E. Tuomisto reports costs for attending an international congress and costs for lecture from Boehringer Ingelheim, and costs for a lecture from AstraZeneca, outside the submitted work.Conflict of interest: Dr. Niemelä has nothing to disclose.Conflict of interest: Dr. Lehtimäki reports personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, personal fees from Circassia, personal fees from GSK, personal fees from Novartis, personal fees from Mundipharma, personal fees from Orion Pharma, personal fees from Sanofi, personal fees from Teva, outside the submitted work.Conflict of interest: P. Ilmarinen reports a grant for analysis and write-up of a study, and a fee for a lecture from AstraZeneca; fees for lectures from Mundipharma and GlaxoSmithKline; and a fee for a lecture and for preparing presentation material from Novartis, all outside the submitted work. %U https://openres.ersjournals.com/content/erjor/early/2020/12/17/23120541.00715-2020.full.pdf