Omalizumab therapy for asthma patients with poor adherence to inhaled corticosteroid therapy

Hendeles, Leslie; Khan, Yasmeen; Shuster, Jonathan J.; Chesrown, Sarah E.; Abu-Hasan, Mutasim

doi:10.1016/j.anai.2014.10.012

Cited by 25 publications

(20 citation statements)

References 22 publications

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“…An FEV1 improvement with omalizumab could be associated with patients who did not take their ICS properly. In a study assessing the omalizumab effect in patients with poor adherence to ICS, the mean FEV1 value increased by 6% with omalizumab . Finally, the optimum number of patients, calculated before the study to find a difference in FEV1 between responders and nonresponders, was not reached.…”

Section: Discussionmentioning

confidence: 97%

Lung function parameters in omalizumab responder patients: An interesting tool?

Paganin

Mangiapan

Proust

et al. 2017

Allergy

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Section: Discussionmentioning

confidence: 97%

Lung function parameters in omalizumab responder patients: An interesting tool?

Paganin

Mangiapan

Proust

et al. 2017

Allergy

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“…Data regarding adherence patterns in patients treated with omalizumab are limited and the evidence is weakened by methodological differences across the studies [44]. However, despite the reported drop-out rates, adherence to omalizumab appears to be slightly higher than that observed with other anti-asthmatic drugs [45, 46]. Therefore, omalizumab therapy has been proposed as an alternative for patients with poorly controlled asthma for whom adherence does not improve with conventional interventions [46].…”

Section: Discussionmentioning

confidence: 99%

“…However, despite the reported drop-out rates, adherence to omalizumab appears to be slightly higher than that observed with other anti-asthmatic drugs [45, 46]. Therefore, omalizumab therapy has been proposed as an alternative for patients with poorly controlled asthma for whom adherence does not improve with conventional interventions [46]. One possible explanation is that compared with oral or inhaled treatments, omalizumab is regularly administered in a hospital setting under direct medical supervision thereby improving treatment adherence.…”

Section: Discussionmentioning

confidence: 99%

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

et al. 2016

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BackgroundIn patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database.ResultsIn RCTs the drop-out rate ranged from 7.1 to 19.4 %. Although the reasons for withdrawal were only occasionally reported, patient decision and adverse events were the most frequently reported causes. In real-life studies the drop-out rate ranged from 0 to 45.5 %. In most cases lack of efficacy was responsible for treatment discontinuation. According to NEONet data, 32 % of treated patients dropped out, with an increasing number of drop outs observed over time. Patient decision and lack of efficacy accounted for most treatment withdrawals.ConclusionsTreatment adherence is particularly crucial in patients with severe asthma considering the clinical impact of the disease and the cost of non-adherence. The risk of treatment discontinuation has to be carefully considered both in the experimental and real-life settings. Increased knowledge regarding the main reasons for patient withdrawal is important to improve adherence in clinical practice.

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“…In a small trial of 6-to 26-year-old poorly compliant symptomatic asthmatic patients requiring ICSs with or without LABAs, the addition of omalizumab resulted in fewer exacerbations requiring OCSs than placebo, despite continued noncompliance with inhaled controllers. 108 Patients 12 to 75 years old in the EXTRA study had greater reductions in asthma exacerbations with omalizumab if they had ''high'' baseline levels, based on median split, of the type 2 inflammatory markers FENO, peripheral eosinophil count, and periostin compared with those with ''low'' levels. 102,109,110 Similarly, in the ICATA trial patients with a FENO value of 20 ppb or greater, a peripheral eosinophil count of 2% or greater, and a body mass index of 25 kg/m 2 or greater had a significantly lower number of exacerbations with omalizumab compared with those with lower values of these parameters.…”

Section: Omalizumabmentioning

confidence: 99%

New and future strategies to improve asthma control in children

Anderson

Szefler

2015

Journal of Allergy and Clinical Immunology

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Symptomatic asthma in childhood has lifelong effects on lung function and disease severity, emphasizing the need for improved pediatric asthma control. Control of pediatric risk and impairment domains can be achieved through increased medication adherence or new therapeutic strategies. Developing electronic monitoring device technology with reminders might be a key noninvasive resource to address poor adherence in children and adolescents in a clinical setting. In patients who have persistently poor control despite optimal medication compliance, newly emerging pharmaceuticals, including inhaled therapies and biologics, might be key to their treatment. However, barriers exist to their development in the pediatric population, and insights must be drawn from adult studies, which has its own unique limitations. Biomarkers to direct the use of such potentially expensive therapies to those patients most likely to benefit are imperative. In this review the current literature regarding strategies to improve pediatric asthma control is addressed with the goal of exploring the potential and pitfalls of strategies that might be available in the near future.

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Omalizumab therapy for asthma patients with poor adherence to inhaled corticosteroid therapy

Abstract: openAccessArticle: Falsecover date: 2015-01-01pii: S1081-1206(14)00748-0Harvest Date: 2016-01-06 13:08:17issueName:Page Range: 58-58href scidir: http://www.sciencedirect.com/science/article/pii/S1081120614007480pubType: Original ArticleIntervention

Cited by 25 publications

References 22 publications

Lung function parameters in omalizumab responder patients: An interesting tool?

Lung function parameters in omalizumab responder patients: An interesting tool?

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

New and future strategies to improve asthma control in children

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