Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma

Abstract Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS), which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab (OMA) to mepolizumab (MEP) in patients...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Giovanna Elisiana Carpagnano, Emanuela Resta, Massimiliano Povero, Corrado Pelaia, Mariella D’Amato, Nunzio Crimi, Nicola Scichilone, Giulia Scioscia, Onofrio Resta, Cecilia Calabrese, Girolamo Pelaia, Maria Pia Foschino Barbaro
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d722a816d07e45d5b82ef3965833a969
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d722a816d07e45d5b82ef3965833a969
record_format	dspace
spelling	oai:doaj.org-article:d722a816d07e45d5b82ef3965833a9692021-12-02T11:37:26ZClinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma10.1038/s41598-021-84895-22045-2322https://doaj.org/article/d722a816d07e45d5b82ef3965833a9692021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84895-2https://doaj.org/toc/2045-2322Abstract Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS), which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab (OMA) to mepolizumab (MEP) in patients eligible for both biologics, but not optimally controlled by omalizumab. We retrospectively enrolled uncontrolled severe asthmatic patients who switched from OMA to MEP during the last two years. Information included blood eosinophil count, asthma control test (ACT), spirometry, serum IgE, fractional exhaled nitric oxide (FeNO), OCS intake, drugs, exacerbations/hospitalizations, visits and diagnostic exams. Within the perspective of Italian National Health System, a pre- and post-MEP 12-month standardized total cost per patient was calculated. 33 patients were enrolled: five males, mean age 57 years, disease onset 24 years. At OMA discontinuation, 88% were OCS-dependent with annual mean rate of 4.0 clinically significant exacerbations, 0.30 exacerbations needing emergency room visits or hospitalization; absenteeism due to disease was 10.4 days per patient. Switch to MEP improved all clinical outcomes, reducing total exacerbation rate (RR = 0.06, 95% CI 0.03–0.14), OCS-dependent patients (OR = 0.02, 95% CI 0.005–0.08), and number of lost working days (Δ = − 7.9, 95% CI − 11.2 to − 4.6). Pulmonary function improved, serum IgE, FeNO and eosinophils decreased. Mean annual costs were €12,239 for OMA and €12,639 for MEP (Δ = €400, 95% CI − 1588–2389); the increment due to drug therapy (+ €1,581) was almost offset by savings regarding all other cost items (− €1,181). Patients with severe eosinophilic asthma, not controlled by OMA, experienced comprehensive benefits by switching to MEP with only slight increases in economic costs.Giovanna Elisiana CarpagnanoEmanuela RestaMassimiliano PoveroCorrado PelaiaMariella D’AmatoNunzio CrimiNicola ScichiloneGiulia SciosciaOnofrio RestaCecilia CalabreseGirolamo PelaiaMaria Pia Foschino BarbaroNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Giovanna Elisiana Carpagnano Emanuela Resta Massimiliano Povero Corrado Pelaia Mariella D’Amato Nunzio Crimi Nicola Scichilone Giulia Scioscia Onofrio Resta Cecilia Calabrese Girolamo Pelaia Maria Pia Foschino Barbaro Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
description	Abstract Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS), which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab (OMA) to mepolizumab (MEP) in patients eligible for both biologics, but not optimally controlled by omalizumab. We retrospectively enrolled uncontrolled severe asthmatic patients who switched from OMA to MEP during the last two years. Information included blood eosinophil count, asthma control test (ACT), spirometry, serum IgE, fractional exhaled nitric oxide (FeNO), OCS intake, drugs, exacerbations/hospitalizations, visits and diagnostic exams. Within the perspective of Italian National Health System, a pre- and post-MEP 12-month standardized total cost per patient was calculated. 33 patients were enrolled: five males, mean age 57 years, disease onset 24 years. At OMA discontinuation, 88% were OCS-dependent with annual mean rate of 4.0 clinically significant exacerbations, 0.30 exacerbations needing emergency room visits or hospitalization; absenteeism due to disease was 10.4 days per patient. Switch to MEP improved all clinical outcomes, reducing total exacerbation rate (RR = 0.06, 95% CI 0.03–0.14), OCS-dependent patients (OR = 0.02, 95% CI 0.005–0.08), and number of lost working days (Δ = − 7.9, 95% CI − 11.2 to − 4.6). Pulmonary function improved, serum IgE, FeNO and eosinophils decreased. Mean annual costs were €12,239 for OMA and €12,639 for MEP (Δ = €400, 95% CI − 1588–2389); the increment due to drug therapy (+ €1,581) was almost offset by savings regarding all other cost items (− €1,181). Patients with severe eosinophilic asthma, not controlled by OMA, experienced comprehensive benefits by switching to MEP with only slight increases in economic costs.
format	article
author	Giovanna Elisiana Carpagnano Emanuela Resta Massimiliano Povero Corrado Pelaia Mariella D’Amato Nunzio Crimi Nicola Scichilone Giulia Scioscia Onofrio Resta Cecilia Calabrese Girolamo Pelaia Maria Pia Foschino Barbaro
author_facet	Giovanna Elisiana Carpagnano Emanuela Resta Massimiliano Povero Corrado Pelaia Mariella D’Amato Nunzio Crimi Nicola Scichilone Giulia Scioscia Onofrio Resta Cecilia Calabrese Girolamo Pelaia Maria Pia Foschino Barbaro
author_sort	Giovanna Elisiana Carpagnano
title	Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
title_short	Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
title_full	Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
title_fullStr	Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
title_full_unstemmed	Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
title_sort	clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d722a816d07e45d5b82ef3965833a969
work_keys_str_mv	AT giovannaelisianacarpagnano clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT emanuelaresta clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT massimilianopovero clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT corradopelaia clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT marielladamato clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT nunziocrimi clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT nicolascichilone clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT giuliascioscia clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT onofrioresta clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT ceciliacalabrese clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT girolamopelaia clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma AT mariapiafoschinobarbaro clinicalandeconomicconsequencesofswitchingfromomalizumabtomepolizumabinuncontrolledsevereeosinophilicasthma
_version_	1718395791542845440

Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma

Ejemplares similares