Severe eosinophilic bronchial asthma: new therapeutic options

Nenasheva, N.M.

doi:10.21518/2079-701x-2018-15-44-52

Cited by 7 publications

(4 citation statements)

References 30 publications

(35 reference statements)

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“…Важной характеристикой тяжелой БА являются частые и тяжелые обострения и госпитализация по этому поводу (определяемые как поступление в стационар и / или обследование и лечение в медицинском учреждении в течение ≥ 24 ч) [3,4]. По данным исследований показано, что больные ТБА по сравнению с пациентами с легкой и среднетяжелой БА в 15 раз чаще обращаются за неотложной помощью и в 20 раз чаще попадают в стационар [5].…”

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“…Эозинофильное воспаление наблюдается примерно у 50 % пациентов с БА и связано с тяжестью заболевания, большей частотой обострений и снижением функции легких [3,4]. Кроме того, плохой конт-For citation: Demko I.V., Sobko E.A., Kraposhina A.Yu., Shestakova N.A.…”

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“…У больных ТЭБА преимущественно наблюдается позднее начало заболевания, преобладает эозинофильный тип воспаления (эозинофилы крови ≥ 300 кл. / мкл), наблюдаются частые обострения; прогноз течения БА -неблагоприятный [3].…”

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Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Demko

Собко

Kraposhina

et al. 2023

Pulʹmonologiâ (Mosk.)

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Patients with severe bronchial asthma, which remains uncontrolled despite the optimal basic therapy, carry a significant healthcare burden and require substantial financial investments. Severe asthma is a heterogeneous airway disease with complex pathophysiological mechanisms that can be broadly divided into inflammatory pathways with eosinophilic and non-eosinophilic inflammation.Aim. This study aimed to analyze the literature data on the use of targeted genetic engineering therapy in patients with severe bronchial asthma, as well as to analyze the organization of immunobiological therapy in the Krasnoyarsk Territory. The addition of targeted drugs for severe eosinophilic bronchial asthma based on phenotyping has proven to be effective and is recommended by all current guidelines. Today, several biologics targeting specific endotypes and phenotypes has been approved for the treatment of severe eosinophilic asthma worldwide. These are antibodies binding immunoglobulin E (omalizumab), antagonists of interleukin-5 (mepolizumab, reslizumab) and its receptor (benralizumab), as well as antibodies selectively binding to the IL-4 and IL-13 receptors (dupilumab). Eosinophilic inflammation therapy is a relatively new direction of asthma treatment, and understanding its long-term efficacy and safety is important.Conclusion. It is essential to differentiate patients with severe eosinophilic asthma from the general cohort of asthma patients, timely refer them to specialists who can prescribe this therapy and have experience with it, select the drug correctly, and monitor the patients during the treatment. This article describes organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk Territory.

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Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Demko

Собко

Kraposhina

et al. 2023

Pulʹmonologiâ (Mosk.)

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“…[15] было показано, что в течение года на 1 пациента с легкой, средней и тяжелой БА приходится 0,76, 2,31 и 7,19 потерянных школьных и рабочих дней, соответственно, в пересчете на непрямые затраты это приводит к дополнительным тратам на 1 человека в течение года в размере 106, 321 и 1000 долларов США. Особое внимание заслуживает тяжелое течение БА, так в данном случае речь идет не только о более существенных экономических затратах, но и о значительном снижении качества жизни и увеличении риска смерти [16,17]. Например, в Турции ежегодно на 1 пациента с тяжелой формой БА тратится около 4,4 тыс.…”

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Economic Aspects of Application of the Russian Biosimilar Omalizumab in Patients With Atopic Bronchial Asthma of Moderate to Severe Clinical Courses

Krysanova

Ермолаева

et al. 2021

Farm. farmakol. (Pâtigorsk)

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A certain success in the treatment of bronchial asthma is associated with the introduction of monoclonal antibodies into the treatment process. They made it possible to improve the control of the disease. A number of original genetically engineered biological drugs, such as benralizumab, reslizumab, dupilumab, mepolizumab and omalizumab, are currently registered in Russia. In 2020, this list was supplemented by the first Russian biosimilar drug omalizumab – Genolar® (JSC Generium, Russia). High rates of the development of modern medicine are closely related to the use of biosimilars. The prescription of biosimilars today often makes it possible to provide a larger number of patients with modern drugs at lower costs.The aim of the study was a comprehensive pharmacoeconomic assessment of the application of the domestic biosimilar drug omalizumab in the treatment of patients suffering from moderate and severe atopic bronchial asthma.Materials and methods. At the first stage, an information search in the available databases (Cochrane Library, MedLine, Embase, eLIBRARY) was carried out. According to the results obtained, a meta-analysis (Agache I. et al.) was found out; within its framework, the efficacy and safety of the use of several monoclonal antibodies was assessed. Dupilumab was chosen as the reference drug. Pharmacoeconomic analyses were carried out using a “Cost-Minimization Analysis” (CMA) and a “Budget Impact Analysis” (BIA). Taking into account various options of bronchial asthma, the developed algorithm for providing medical care to adult patients with atopic asthma made it possible to assess the costs, including direct medical and indirect costs.Results. The cost analysis demonstrated the advantage of using the Russian biosimilar omalizumab in patients with atopic asthma compared to dupilumab due to financial savings of up to 40%. The Budget Impact Analysis showed that the use of the domestic biosimilar omalizumab, even taking into account the annual increase in the number of patients (8%), will save up to 109,641,409.64 rubles (or 3%) compared to the current practice.Conclusion. The use of the domestic biosimilar omalizumab in patients with moderate to severe atopic bronchial asthma is a clinically effective and economically justified approach to organizing medical care for adult patients in Russia.

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Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region

et al. 2021

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Objective: scientific rationale of changing approaches to medical care payment for hospitalization of patients suffering from severe asthma (SA) that require the prescription of biologic disease-modifying drugs (bDMDs) within the constraints of diagnosis-related groups (DRGs) on the level of the Moscow Region.Material and methods. For the federal model regional adaptation, the authors used the mechanism of subgroups selection in the structure of basic DRG No. 336 st36.003 and No. 139 ds36.004 “Treatment with biologic disease-modifying drugs and selective immunosuppressants” in the round-the-clock (RH) and day-time hospital (DH). Budget impact analysis (BIA) was performed to provide scientific and economic feasibility for the improvement of medical care payment for bDMDs proscribed to patients with SA within DRG at the level of the Moscow Region.Results. The analysis of cost of drug therapy and medical services per 1 case of hospitalization of patients with SA, that required bDMDs therapy, considering the classification criterion (international nonproprietary name of drugs and drug therapy regimens), showed 10 subgroups in DRG No. 336 st36.003 (level 1) and 9 subgroups in DRG No. 139 ds36.004. Expert estimates on the rate of hospitalizations and drug dosage regimen indicated for patients with SA were used to calculate the relative cost weights (CW). The highest CW was observed in the subgroup that received benralizumab in RH (CW=7.46) and in DH (CW=12.08) conditions. BIA demonstrated 110,103,901.53 rubles (or 31%) budget savings for the health care system of the Moscow Region.Conclusion. The implementation of the adapted DRG federal model in the conditions of the health care system of Moscow Region is an economically feasible approach to the organization of the inpatient medical care provided to patients with SA needing bDMDs prescription.

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Severe eosinophilic bronchial asthma: new therapeutic options

Cited by 7 publications

References 30 publications

Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Organization of biological therapy for patients with severe eosinophilic bronchial asthma in the Krasnoyarsk region

Economic Aspects of Application of the Russian Biosimilar Omalizumab in Patients With Atopic Bronchial Asthma of Moderate to Severe Clinical Courses

Medical care payment improvement within diagnosis-related groups of patients with severe asthma requiring biologic disease-modifying drugs by regional adaptation mechanism in the Moscow Region

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