Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2021
Real-world effectiveness of mepolizumab in patients with severe asthma and associated comorbidities.
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Casale Thomas, Molfino Nestor A, Silver Jared, Bogart Michael, Packnett Elizabeth, McMorrow Donna, Wu Joanne, Hahn Beth
Аннотация
BACKGROUND: Patients with severe asthma frequently have associated comorbidities, which can compound existing symptoms, complicating asthma management.
OBJECTIVE: To describe the real-world effectiveness of mepolizumab in patients with severe asthma stratified by common overlapping comorbidities.
METHODS: This was a retrospective analysis of patients with asthma from the MarketScan Commercial and Medicare Supplemental Database initiating mepolizumab treatment (index date). Eligible patients had more than or equal to 1 claim (excluding claims for diagnostic tests) with a diagnosis code for more than or equal to 1 of 7 comorbidities (atopic disease, nasal polyps, chronic sinusitis, obesity, respiratory infections, chronic obstructive pulmonary disease, and depression/anxiety) during the 12-month preindex baseline period; these were used to stratify patients into 7 nonmutually exclusive subgroups. Outcomes included asthma exacerbations and exacerbation-related health care resource utilization during the 12-month baseline and follow-up periods. Each patient acted as their own control.
RESULTS: Of the 639 patients included, the most common comorbidities were atopic diseases (73.2%), respiratory infections (55.6%), and chronic sinusitis (45.1%). Across all 7 comorbidity subgroups, there were significant (P < .05) reductions of 38% to 55% and 57% to 83% in exacerbations and exacerbations requiring hospitalization, respectively, during the follow-up vs baseline period, except for exacerbations requiring hospitalization in the nasal polyp subgroup, owing to the small subgroup sample size. During the follow-up vs baseline periods, mean number of oral corticosteroids claims was significantly (P < .001) reduced by 29% to 38%; 39% to 47% of patients achieved greater than or equal to 50% oral corticosteroids dose reduction. Significant reductions in exacerbation-related health care resource utilization were also observed.
CONCLUSION: Mepolizumab treatment provided real-world clinical benefits in patients.
OBJECTIVE: To describe the real-world effectiveness of mepolizumab in patients with severe asthma stratified by common overlapping comorbidities.
METHODS: This was a retrospective analysis of patients with asthma from the MarketScan Commercial and Medicare Supplemental Database initiating mepolizumab treatment (index date). Eligible patients had more than or equal to 1 claim (excluding claims for diagnostic tests) with a diagnosis code for more than or equal to 1 of 7 comorbidities (atopic disease, nasal polyps, chronic sinusitis, obesity, respiratory infections, chronic obstructive pulmonary disease, and depression/anxiety) during the 12-month preindex baseline period; these were used to stratify patients into 7 nonmutually exclusive subgroups. Outcomes included asthma exacerbations and exacerbation-related health care resource utilization during the 12-month baseline and follow-up periods. Each patient acted as their own control.
RESULTS: Of the 639 patients included, the most common comorbidities were atopic diseases (73.2%), respiratory infections (55.6%), and chronic sinusitis (45.1%). Across all 7 comorbidity subgroups, there were significant (P < .05) reductions of 38% to 55% and 57% to 83% in exacerbations and exacerbations requiring hospitalization, respectively, during the follow-up vs baseline period, except for exacerbations requiring hospitalization in the nasal polyp subgroup, owing to the small subgroup sample size. During the follow-up vs baseline periods, mean number of oral corticosteroids claims was significantly (P < .001) reduced by 29% to 38%; 39% to 47% of patients achieved greater than or equal to 50% oral corticosteroids dose reduction. Significant reductions in exacerbation-related health care resource utilization were also observed.
CONCLUSION: Mepolizumab treatment provided real-world clinical benefits in patients.
Предметные рубрики MeSH
Adrenal Cortex HormonesAdultAgedAnti-Asthmatic AgentsAntibodies, Monoclonal, HumanizedAnxietyAsthmaChronic DiseaseComorbidityDepressionFemaleHumansMaleMiddle AgedNasal PolypsObesityPatient Acceptance of Health CareRespiratory Tract InfectionsRetrospective StudiesSeverity of Illness IndexSinusitisTreatment Outcome