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Review
. 2016 Aug 25;16(1):128.
doi: 10.1186/s12890-016-0290-5.

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

M Caminati  1 , G Senna  2 , G Stefanizzi  2 , R Bellamoli  2 , S Longhi  2 , F Chieco-Bianchi  3 , G Guarnieri  4 , S Tognella  5 , M Olivieri  6 , C Micheletto  7 , G Festi  8 , E Bertocco  9 , M Mazza  10 , A Rossi  8 , A Vianello  3 ; North East Omalizumab Network study group
Collaborators, Affiliations
Review

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

M Caminati et al. BMC Pulm Med. .

Abstract

Background: In patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database.

Results: In RCTs the drop-out rate ranged from 7.1 to 19.4 %. Although the reasons for withdrawal were only occasionally reported, patient decision and adverse events were the most frequently reported causes. In real-life studies the drop-out rate ranged from 0 to 45.5 %. In most cases lack of efficacy was responsible for treatment discontinuation. According to NEONet data, 32 % of treated patients dropped out, with an increasing number of drop outs observed over time. Patient decision and lack of efficacy accounted for most treatment withdrawals.

Conclusions: Treatment adherence is particularly crucial in patients with severe asthma considering the clinical impact of the disease and the cost of non-adherence. The risk of treatment discontinuation has to be carefully considered both in the experimental and real-life settings. Increased knowledge regarding the main reasons for patient withdrawal is important to improve adherence in clinical practice.

Keywords: Adherence; Drop-out; Omalizumab; Severe asthma.

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Figures

Fig. 1
Fig. 1
Drop-out rates in different treatment duration time intervals (NEONet database; n = 221). The blue lines indicate the 95 % Confidence Interval (CI)
See this image and copyright information in PMC

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