Clinical and Healthcare Cost Characteristics of Severe Asthma Patients with Long-Term Control on Omalizumab: A Comparative Analysis with Patients Who Switched to Other Biologics.

BACKGROUND AND PURPOSE

Biologics are crucial for severe asthma treatment, but their high costs pose challenges. Omalizumab (OML) is dosed on the basis of patient-specific factors. The purpose of this study is to clarify the clinical characteristics of severe asthmatics who maintain long-term control on omalizumab including healthcare cost considerations.

PATIENTS AND METHODS

A retrospective, multicenter cohort study was conducted. Patients receiving OML at three institutions were enrolled. Patients continuing OML (C-OML) were compared with those switching to other biologics (S-OML) in terms of clinical background, cost-effectiveness, and type-2 inflammation levels.

RESULTS

Forty-seven patients were enrolled. The C-OML group achieved exacerbation control comparable to that of the S-OML group, with a median OML dose of 300 mg/month, resulting in significantly lower personal payments ( < 0.01). Compared with the S-OML group, the C-OML group had a greater prevalence of overweight ( = 0.04), a lower prevalence of eosinophilic chronic rhinosinusitis ( < 0.01), and a trend toward a higher prevalence of allergic rhinitis ( = 0.06). Effective asthma control with OML was associated with nonsevere type-2 inflammation (eosinophils < 300/μL and FeNO < 50 ppb).

CONCLUSION

Patients with nonsevere type-2 inflammation and a high BMI can achieve effective asthma control with OML, reducing treatment costs. Identifying this phenotype can improve the cost-effectiveness of biologic therapies for patients with severe asthma.