Relationship between adherence, atopic status and symptom
control
In order to determine whether change in symptom control with ICS
treatment was related to objective biomarkers that determine steroid
responsiveness, we assessed adherence and TRACK score at baseline and
follow-up in atopic and non-atopic wheezers separately. Overall
adherence was similar in atopic and non-atopic children (Table 3). There
was a significant and clinically meaningful increase (TRACK increase of
>10) in symptom score only in atopic wheezers from baseline
to follow-up (Table 3 & Fig 2A), while TRACK remained similar in
non-atopic wheezers (Fig 2B). When all atopic wheezers were divided into
those with moderate or good adherence (> 60%),
compared to those with poor adherence (<60%), only atopic
wheezers with adherence > 60% had a significant
increase in TRACK score from baseline to follow-up visits (Fig 3). This
suggests symptom control and ICS adherence are only positively related
in the sub-group of wheezers who have a steroid responsive phenotype.