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Open Access Asthma control, lung function, symptoms, and corticosteroid sparing after omalizumab initiation in patients with allergic asthma

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Background:

Omalizumab is approved in patients with moderate-to-severe allergic asthma with symptoms uncontrolled, despite the mainstay therapy.

Objective:

Electronic medical records (EMR) were used to increase the knowledge of omalizumab effectiveness in a real-world setting.

Methods:

Patients with uncontrolled moderate-to-severe allergic asthma, ages ≥12 years old, initiated on omalizumab (index date), with ≥12 months of pre- and postindex data, were identified in an EMR data base. An Asthma Control Test score (≥20 is considered well controlled), forced expiratory volume in 1 second as a percentage of the predicted value (<80% considered below normal), symptoms, and oral corticosteroid (OCS) and inhaled corticosteroid (ICS) use were compared in the 12-month post- versus the preindex period with univariate generalized estimating equations adjusted for repeated measurements.

Results:

A total of 208 patients (mean ± standard deviation[SD] age, 41 ± 19 years; 64.9% women; 71.2% white; and with a mean ± SD serum total immunoglobulin E level of 455.4 ± 644.7 IU/mL) were identified. In the post- versus preindex period, the patients were significantly more likely to have well-controlled asthma (odds ratio [OR] 1.72 [95% confidence interval {CI}, 1.11‐2.64]) and less likely to have a lung function value below normal (nonsignificant) after omalizumab initiation. The patients experienced significantly less coughing (OR 0.66 [95% CI, 0.49‐0.91]), shortness of breath (OR 0.60 [95% CI, 0.44‐0.83]), and wheezing (OR 0.59 [95% CI, 0.43‐0.81]), with no improvement in chest tightness. A significantly lower likelihood of new OCS prescriptions (OR 0.58 [95% CI, 0.41‐0.82]) was observed. A lower likelihood of new high- and medium-dose ICS prescriptions was nonsignificant.

Conclusion:

Omalizumab was associated with beneficial effects on asthma control and symptoms, and the likelihood of requiring new OCS prescriptions. An observed trend of improved lung function and lower likelihood of requiring high- and medium-dose ICS did not reach statistical significance.
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Keywords: Allergic asthma; anti-IgE antibody; asthma control test; clinical outcomes; electronic medical records; lung function; moderate-to-severe asthma; omalizumab; symptoms; uncontrolled asthma

Document Type: Research Article

Affiliations: 1: Analysis Group Inc., Montreal, Quebec, Canada 2: Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA 3: Allergy Partners P.A., Asheville, North Carolina, USA

Publication date: March 1, 2018

This article was made available online on December 5, 2017 as a Fast Track article with title: "Asthma control, lung function, symptoms, and corticosteroid sparing after omalizumab initiation in patients with allergic asthma".

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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