From Respiratory, U.S. Medical Affairs, GlaxoSmithKline (GSK), La Jolla, California.
Respiratory, U.S. Medical Affairs, GSK Research Triangle Park, North Carolina.
Allergy Asthma Proc. 2019 May 1;40(3):146-153. doi: 10.2500/aap.2019.40.4220. Epub 2019 Mar 29.
Real-world data on the characteristics and burden of disease among patients with asthma before receiving asthma-specific biologics would improve the understanding of the use of these therapies in a clinical setting. Currently, limited data are available on the use of mepolizumab and omalizumab for the treatment of asthma. To determine the characteristics and disease burden among patients with asthma before initiating treatment with mepolizumab or omalizumab. This was a retrospective cohort analysis of commercial and Medicare Advantage Plan members from a medical claims database with a new claim for mepolizumab or omalizumab between January 1, 2015, and March 31, 2017 (GSK ID: HO-17-18283). Eligible patients had a diagnosis of asthma and continuous enrollment in the health plan, with clinical and pharmacy benefits for 12 months before initiating asthma-specific biologic treatment (baseline period), and no diagnosis of chronic idiopathic urticaria during the baseline period. Patient characteristics, exacerbations, and asthma-related health care resource utilization and costs were assessed during the baseline period. Overall, 188 and 901 patients prescribed mepolizumab and omalizumab, respectively, were included. In the 12 months before initiating asthma-specific biologic therapy, the patients prescribed mepolizumab were older, had higher blood eosinophil counts, more-frequent exacerbations (2.9 versus 2.0 exacerbations/year; p < 0.001), and more inhaled corticosteroid and systemic corticosteroid use compared with those prescribed omalizumab. Overall, asthma-related health-care resource utilization and costs were similar across both treatment cohorts, although patients prescribed mepolizumab had more pharmacy fills, higher pharmacy costs, and lower clinic costs compared with patients prescribed omalizumab (20.8 versus 16.9 fills, $4504 versus $3102, and $1816 versus $2709, respectively; all p < 0.001). In the 12 months before initiating asthma-specific biologic therapy, the patients prescribed mepolizumab may have a greater disease burden than those prescribed omalizumab. Overall, health-care resource utilization and costs were broadly similar across both treatment cohorts.
在接受哮喘特异性生物制剂治疗之前，关于哮喘患者特征和疾病负担的真实世界数据将有助于更好地了解这些疗法在临床环境中的应用。目前，关于美泊利珠单抗和奥马珠单抗治疗哮喘的使用数据有限。本研究旨在确定接受美泊利珠单抗或奥马珠单抗治疗前哮喘患者的特征和疾病负担。这是一项回顾性队列分析，纳入了来自医疗索赔数据库的商业保险和医疗保险优势计划成员，这些成员在 2015 年 1 月 1 日至 2017 年 3 月 31 日期间有美泊利珠单抗或奥马珠单抗的新索赔（GSK ID：HO-17-18283）。符合条件的患者有哮喘诊断，在开始哮喘特异性生物治疗前（基线期）有 12 个月的健康计划连续入组，且在基线期内无慢性特发性荨麻疹诊断。在基线期评估患者特征、加重情况以及与哮喘相关的医疗保健资源利用和费用。共有 188 名和 901 名分别接受美泊利珠单抗和奥马珠单抗治疗的患者被纳入分析。在开始哮喘特异性生物治疗前的 12 个月内，接受美泊利珠单抗治疗的患者年龄更大，血嗜酸性粒细胞计数更高，加重次数更频繁（2.9 次/年比 2.0 次/年；p < 0.001），吸入性皮质类固醇和全身性皮质类固醇的使用也更多。总体而言，与接受奥马珠单抗治疗的患者相比，接受美泊利珠单抗治疗的患者的哮喘相关医疗保健资源利用和费用相似，尽管接受美泊利珠单抗治疗的患者的药物配药量更多，药物费用更高，而就诊费用更低（分别为 20.8 次与 16.9 次、4504 美元与 3102 美元以及 1816 美元与 2709 美元；均 p < 0.001）。在开始哮喘特异性生物治疗前的 12 个月内，接受美泊利珠单抗治疗的患者可能比接受奥马珠单抗治疗的患者疾病负担更大。总体而言，两个治疗组的医疗资源利用和费用基本相似。
