Serum Prednisolone Levels as a Marker of Oral Corticosteroid Adherence in Severe Asthma

J. Michael Ramsahai; Emily King; Robert Niven; Gael Tavernier; Peter A. B. Wark; Jodie L. Simpson


BMC Pulm Med. 2020;20(228) 

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In conclusion, our study demonstrates that serum prednisolone levels could be useful as a measure of adherence to oral prednisolone therapy. In conjunction with sputum eosinophil counts, this can be used to help distinguish non-adherent from steroid resistant T2-high populations, in addition to a population where the opportunity may exist for steroid reduction. This provides an objective method for the assessment of adherence and can help guide clinicians on the next steps in treatment for this challenging population. With further study, serum prednisolone levels could be used to target adherence as a treatable trait and further the concept of precision medicine in severe asthma.