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Serum Inhaled Corticosteroid Detection for Monitoring Adherence in Severe Asthma
Fahad H Alahmadi1, Brian Keevil2, Lynn Elsey2
1School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom; Respiratory Therapy Department, College of Medical Rehabilitation Sciences, Taibah University, Madinah, Saudi Arabia.
Inhaled corticosteroids (ICSs) can be detected in blood for up to 8 hours, offering a new way to measure adherence in severe asthma patients. Lower blood ICS levels correlate with increased exacerbations and poorer lung function.
Area of Science:
- Pharmacology
- Pulmonology
- Clinical Chemistry
Background:
- Daily inhaled corticosteroids (ICSs) are crucial for asthma management.
- Low patient adherence to ICS therapy is a significant challenge.
- Accurate methods to assess adherence are needed.
Purpose of the Study:
- To determine if LC-MS/MS can detect ICSs in serum.
- To investigate the relationship between serum ICS levels and asthma severity markers.
Main Methods:
- Blood samples were collected from severe asthma patients over 8 hours post-inhalation.
- Serum ICS levels were analyzed using LC-MS/MS.
- Correlations between serum ICS levels and disease severity markers were examined.
Main Results:
- ICSs were detectable in serum up to 8 hours post-inhalation for most common ICS medications.
- Low adherence (<80%) was identified in 43% of patients via prescription records.
- Lower blood ICS levels correlated with higher exacerbation rates and, for fluticasone propionate, poorer lung function (FEV1 %predicted).
Conclusions:
- Serum ICS detection is a reliable method to assess adherence in severe asthma.
- Blood ICS levels can serve as an objective biomarker for adherence.
- This method can help identify patients with poor adherence and potentially guide treatment adjustments.
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