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包括开始使用奥马珠单抗治疗的患者在内的儿童过敏性哮喘患者的基线特征描述。

Description of Baseline Characteristics of Pediatric Allergic Asthma Patients Including those Initiated on Omalizumab.

作者信息

Kavati Abhishek, Pilon Dominic, Ortiz Benjamin, Paknis Brandee, Vegesna Ashok, Schiffman Bradd, Zhdanava Maryia, Lefebvre Patrick, Stone Brian

机构信息

Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA.

Analysis Group Inc., Montreal, QC, Canada.

出版信息

Allergy Rhinol (Providence). 2018 Apr 9;9:2152656718763387. doi: 10.1177/2152656718763387. eCollection 2018 Jan-Dec.

Abstract

BACKGROUND

Indication of omalizumab in the United States was recently extended to include pediatric (6-11 years) uncontrolled moderate-to-severe allergic asthma patients.

OBJECTIVE

The purpose of this study was to describe baseline characteristics of this population from a real-world dataset.

METHODS

Allergic asthma patients and uncontrolled moderate-to-severe allergic asthma patients, aged 6-11 years, were identified in the Allergy Partners Network Electronic Medical Records (2007-2016). The index date for allergic asthma patients was the latest between the second asthma-related visit and the allergic status confirmation. Uncontrolled moderate-to-severe allergic asthma patients were stratified into omalizumab-exposed (index date) or omalizumab-unexposed (index date randomly generated) groups. Characteristics were evaluated during the 12-month preindex period.

RESULTS

A total of 5806 allergic asthma, 37 omalizumab-exposed, and 2620 omalizumab-unexposed patients were selected (mean age approximately 9 years). Allergic asthma and omalizumab-unexposed patients were predominantly white (70.2% and 61.2%) whereas the majority of omalizumab-exposed were African Americans (62.2%). Mean immunoglobulin E was 782.0 IU/ml in allergic asthma patients (available in 2.2%), 1134.4 IU/ml in omalizumab-exposed (available in 100.0%), and 746.1 IU/ml in omalizumab-unexposed (available in 3.1%). Allergic asthma patients were less severe than omalizumab-exposed and omalizumab-unexposed based on the forced expiratory volume in 1 s as a percentage of predicted value (FEV% predicted) and the Childhood Asthma Control Test (C-ACT). FEV% predicted was below normal (<80%) in 42.4% of omalizumab-exposed and 39.1% of omalizumab-unexposed patients, also 63.6% of omalizumab-exposed and 46.7% of omalizumab-unexposed had uncontrolled asthma (C-ACT score <20). In African American omalizumab-exposed patients, FEV% predicted was below normal in 47.6% and 55.0% had uncontrolled asthma.

CONCLUSIONS

In a real-world setting, pediatric patients with uncontrolled moderate-to-severe allergic asthma have a significant disease burden as shown by high rates of poor lung function, disease control, and symptoms. Currently available treatments could help improve disease management in this population.

摘要

背景

美国奥马珠单抗的适应证最近扩大到包括6至11岁未得到控制的中重度过敏性哮喘患儿。

目的

本研究旨在通过一个真实世界数据集描述该人群的基线特征。

方法

在过敏伙伴网络电子病历中(2007 - 2016年)识别出年龄在6至11岁的过敏性哮喘患者和未得到控制的中重度过敏性哮喘患者。过敏性哮喘患者的索引日期为第二次哮喘相关就诊和过敏状态确认两者中较晚的日期。未得到控制的中重度过敏性哮喘患者被分层为接受奥马珠单抗治疗(索引日期)或未接受奥马珠单抗治疗(随机生成索引日期)组。在索引前12个月期间评估特征。

结果

共选取了5806例过敏性哮喘患者、37例接受奥马珠单抗治疗患者和2620例未接受奥马珠单抗治疗患者(平均年龄约9岁)。过敏性哮喘患者和未接受奥马珠单抗治疗患者主要为白人(分别为70.2%和61.2%),而接受奥马珠单抗治疗的患者多数为非裔美国人(62.2%)。过敏性哮喘患者的平均免疫球蛋白E为782.0 IU/ml(2.2%的患者数据可用),接受奥马珠单抗治疗患者为1134.4 IU/ml(100.0%的患者数据可用),未接受奥马珠单抗治疗患者为746.1 IU/ml(3.1%的患者数据可用)。基于第1秒用力呼气量占预测值的百分比(FEV%预测值)和儿童哮喘控制测试(C - ACT),过敏性哮喘患者的病情严重程度低于接受奥马珠单抗治疗患者和未接受奥马珠单抗治疗患者。42.4%的接受奥马珠单抗治疗患者和39.1%的未接受奥马珠单抗治疗患者的FEV%预测值低于正常水平(<80%),同样,63.6%的接受奥马珠单抗治疗患者和46.7%的未接受奥马珠单抗治疗患者哮喘未得到控制(C - ACT评分<20)。在接受奥马珠单抗治疗的非裔美国患者中,47.6%的患者FEV%预测值低于正常水平,55.0%的患者哮喘未得到控制。

结论

在真实世界中,未得到控制的中重度过敏性哮喘患儿疾病负担较重,表现为肺功能差、疾病控制不佳和症状发生率高。目前可用的治疗方法有助于改善该人群的疾病管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e335/6028162/0e0695ecf8bd/10.1177_2152656718763387-fig1.jpg

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