Chung Yen, Katial Rohit, Mu Fan, Cook Erin E, Young Joshua, Yang Danni, Betts Keith A, Carstens Donna D
AstraZeneca, Wilmington, Delaware.
Analysis Group, Inc., Boston, Massachusetts.
Ann Allergy Asthma Immunol. 2022 Jun;128(6):669-676.e6. doi: 10.1016/j.anai.2022.02.017. Epub 2022 Mar 2.
Real-world evidence characterizing the clinical outcomes and economic impact on patients with severe eosinophilic asthma treated with benralizumab is limited.
To characterize patients with severe asthma treated with benralizumab and assess its clinical and economic impact in the United States.
A pre-post benralizumab comparison was performed using a large US insurance claims database between November 2016 and November 2019. The primary cohort included patients with asthma aged 12 years or more with 2 or more records of benralizumab. Secondary cohorts included persistent users (6 or more records of benralizumab), patients switching to benralizumab from mepolizumab or omalizumab, and stratified by Medicaid vs non-Medicaid. Exacerbations, concomitant medications, and exacerbation-related health care resource utilization (HCRU) and costs were compared in the 12-month periods pre- and post-benralizumab initiation (index).
Of the 204 patients in the primary cohort, mean age at index was 45.3 years and 68.6% were of female sex. The patients experienced a significant 55% reduction in rates of exacerbations post-benralizumab initiation (3.25 pre-index vs 1.47 post-index per person-year; P < .001), and 41% of the patients had no exacerbations post-benralizumab initiation. The proportion of oral corticosteroid-dependent patients decreased from 82% to 50% (P < .001). Reductions in HCRU were 42%, 46%, and 57% for asthma exacerbation-related inpatient hospitalizations, emergency department, and outpatient visits, respectively (all P < .001). Exacerbation-related costs decreased by $6439 ($13,559 vs $7120; P < .001). Similar results for all outcomes were observed for the persistent cohort, switch cohorts, and Medicaid vs non-Medicaid cohorts.
Patients with severe asthma treated with benralizumab experienced clinical and economic benefits in the real world, as demonstrated by the reduction in exacerbations and HCRU.
关于使用贝那利珠单抗治疗严重嗜酸性粒细胞性哮喘患者的临床结局和经济影响的真实世界证据有限。
描述接受贝那利珠单抗治疗的严重哮喘患者的特征,并评估其在美国的临床和经济影响。
在2016年11月至2019年11月期间,使用美国一个大型保险理赔数据库对贝那利珠单抗治疗前后进行比较。主要队列包括年龄在12岁及以上且有2条或更多贝那利珠单抗记录的哮喘患者。次要队列包括持续使用者(有6条或更多贝那利珠单抗记录)、从美泊利珠单抗或奥马珠单抗转换为贝那利珠单抗的患者,并按医疗补助与非医疗补助进行分层。在贝那利珠单抗起始治疗前(索引)和后12个月期间,比较哮喘发作、伴随用药以及与发作相关的医疗资源利用(HCRU)和费用。
主要队列中的204例患者,索引时的平均年龄为45.3岁,68.6%为女性。患者在贝那利珠单抗起始治疗后发作率显著降低55%(索引前每人每年3.25次 vs 索引后1.47次;P <.001),41%的患者在贝那利珠单抗起始治疗后无发作。口服糖皮质激素依赖患者的比例从82%降至50%(P <.001)。与哮喘发作相关的住院、急诊科和门诊就诊的HCRU分别降低了42%、46%和57%(均P <.001)。与发作相关的费用减少了6439美元(13559美元 vs 7120美元;P <.00)。在持续队列、转换队列以及医疗补助与非医疗补助队列中,所有结局均观察到类似结果。
如发作和HCRU的减少所示,接受贝那利珠单抗治疗的严重哮喘患者在现实世界中获得了临床和经济效益。