Association between consistent omalizumab treatment and asthma control.
BACKGROUND
Omalizumab is indicated for patients with moderate-to-severe allergic asthma with inadequately controlled symptoms.


OBJECTIVE
We evaluated the association between consistent omalizumab treatment and asthma control.


METHODS
Health insurance claims from the MarketScan database (2002Q1-2011Q2) were analyzed. Asthmatic patients with ≥12 months of continuous insurance coverage after the first omalizumab claim (index date) after 6 months of continuous omalizumab use were included. A 12-month landmark period was used to assess treatment consistency, defined as uninterrupted treatment without a gap of ≥28 days in omalizumab use. The effect of consistent omalizumab treatment on asthma control between months 13 and 24 was evaluated. Multivariate time-varying Cox regressions were also conducted to assess the adjusted effect of treatment interruption on asthma control from month 1 to month 24.


RESULTS
A total of 3044 patients (mean age, 48.5 years; female, 62%) formed the study population. Patients consistent with omalizumab treatment at 12 months (39% of patients) were less likely to have an uncontrolled asthma event during months 13 to 24 with only 49% of patients experiencing one event compared with 54% in the non consistent subgroup (P = .02). In addition, consistent omalizumab treatment at 12 months was associated with a 51% reduction in the mean number of asthma-related emergency department (ED) visits per patient and a 28% reduction in asthma-related hospitalizations. Multivariate analyses corroborated these findings (hazard ratio for consistent vs non-consistent: risk of short-acting β2-agonists prescription, oral corticosteroids prescription, ED visit, or hospitalization, 0.76; 95% CI, 0.69-0.83]).


CONCLUSIONS
This analysis showed that consistent omalizumab treatment was associated with significant reductions in ED visits and hospitalizations.
Groupe d'analyse, Ltée, Montréal, Québec, Canada.
Marie-Hélène
MH
Lafeuille
Jonathan
J
Gravel
Jie
J
Zhang
Boris
B
Gorsh
Maria
M
Figliomeni
Patrick
P
Lefebvre
D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069444:Omalizumab; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D016903:Drug Monitoring
D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D000069444:Omalizumab
Adherence; Asthma control; Asthma treatment; Claims data; ED; Emergency department; Emergency department visits; HR; Hazard ratio; Hospitalizations; ICS; IDC-9; Inhaled corticosteroids; International Classification of Diseases, Ninth Revision; LABA; Long-acting β(2)-agonists; OCS; Omalizumab; Oral corticosteroids; PDC; Persistence; Proportion of days covered; Resource utilization; SABA; Short-acting β(2)-agonists