Papi A, et al. - In this historical cohort study, researchers investigated if poor adherence to inhaled corticosteroid (ICS) therapy explains the occurrence of asthma exacerbations in patients with elevated blood eosinophil levels. They examined patients within the Optimum Patient Care Research Database, aged ≥18 years, at Global Initiative for Asthma (GINA) steps 3 or 4, with ≥2 ICS prescriptions during the year prior to clinical review, with elevated (>400 cells/μL) or normal (≤400 cells/μL) blood eosinophils. Elevated eosinophils were detected in nearly one in seven patients. No association was found between adherence to ICS therapy and decreased exacerbations. For these patients, additional therapy, such as biologics, which have been previously shown to improve control in severe uncontrolled eosinophilic asthma, were recommended.