Trends in Omalizumab Utilization for Asthma: Evidence of Suboptimal Patient Selection
Trends in Omalizumab Utilization for Asthma: Evidence of Suboptimal Patient Selection
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DOI：
10.1016/j.jaip.2017.07.034
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发表时间：
2018-09-01
影响因子：
9.4
通讯作者：
Rank, Matthew A.
中科院分区：
文献类型：
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作者：
Jeffery, Molly M.;Shah, Nilay D.;Rank, Matthew A.
背景：奥马珠单抗是2003年批准用于非吸入皮质类固醇(ICSS)控制的首个哮喘生物制剂，它的使用趋势可能揭示患者选择方面的教训。目的：描述自2003年推出以来奥马珠单抗的使用模式，重点关注为其启动奥马珠单抗的患者水平的特征。方法：利用美国行政索赔的大型数据库，我们确定了2003至2015年间哮喘的私人保险和医疗保险优势受益者。描述了事件的特征(在过去12个月中没有使用奥马珠单抗)和治疗哮喘的奥马珠单抗的流行使用者，并绘制了奥马利单抗使用趋势图。在奥马利单抗开始使用前6个月，比较了非那利珠单抗使用者和事件奥马珠单抗使用者的人口学特征、ICSS和/或ICS/长效β-激动剂(ICS-LABA)的用药依从性(药物持有率[MPR])、加重频率和哮喘控制情况。结果：我们发现流行的7,658人和事件的3,399人。奥马珠单抗发病率在2004年第二季度达到峰值，每1000名哮喘患者中有0.65人，而患病率在2006年第四季度达到峰值，为3.22人；截至2015年第四季度，发病率分别为0.14和1.96。在奥马珠单抗启动前12个月，72.5%的患者依从性较低(MPR
BACKGROUND: Utilization trends of omalizumab, a first-in-its-class asthma biologic approved in 2003 for individuals not controlled by inhaled corticosteroids (ICSs), may reveal lessons in patient selection.OBJECTIVE: To describe utilization patterns for omalizumab since its introduction in 2003, with a focus on patient-level characteristics of patients for whom omalizumab was initiated.METHODS: Using a large US database of administrative claims, we identified privately insured and Medicare Advantage beneficiaries with asthma between 2003 and 2015. Characteristics of incident (no omalizumab use in the previous 12 months) and prevalent users of omalizumab for asthma were described and omalizumab use trends graphed. A comparison cohort (1: 5 matching proportion) of nonomalizumab users was compared with incident omalizumab users on demographic characteristics, medication adherence (medication possession ratio [MPR]) for ICSs and/or ICS/long-acting beta-agonist (ICS-LABA), exacerbation frequency, and asthma control in the 6 months before omalizumab initiation.RESULTS: We identified 7,658 prevalent and 3,399 incident omalizumab users. Omalizumab incidence peaked in the second quarter of 2004 at 0.65 per 1,000 individuals with asthma, whereas prevalence peaked in the fourth quarter of 2006 at 3.22; as of fourth quarter 2015, rates were 0.14 and 1.96, respectively. In the 12 months before omalizumab initiation, 72.5% had low adherence (MPR