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. 2021 Dec;127(6):648-654.
doi: 10.1016/j.anai.2021.04.026. Epub 2021 May 7.

Persistence of asthma biologic use in a US claims database

Jacob T Maddux  1 , Jonathan W Inselman  2 , Molly M Jeffery  3 , Regina W Lam  4 , Nilay D Shah  5 , Matthew A Rank  6
Affiliations

Persistence of asthma biologic use in a US claims database

Jacob T Maddux et al. Ann Allergy Asthma Immunol. 2021 Dec.

Abstract

Background: Little is known on the persistence of asthma biologic use in clinical practice.

Objective: To evaluate the persistence of asthma biologic use and time to clinical response in clinical practice.

Methods: A cohort of people with asthma who used at least 1 asthma biologic was constructed using data from 2003 to 2019 in the OptumLabs Data Warehouse. Treatment persistence was defined by the length of time that a person continuously used an asthma biologic, allowing for a lapse in use up to 4 months before confirming that a person stopped. Clinical response to treatment (defined as a decline in asthma exacerbations of at least 50% compared with the 6 months before starting an asthma biologic) was described over time and in relation to biologic persistence.

Results: There were 9575 people who had at least 1 episode of asthma biologic use. There were 5319 people (64%, 95% confidence interval, 63%-65%) who completed 6 months or more on an asthma biologic and 3284 (45%, 95% confidence interval, 44%-46%) who completed 12 months or more. Of people with 1 or more asthma exacerbation 6 months before index biologic use, 63%, 76%, 80%, and 81% realized a 50% or more reduction in postindex asthma exacerbations in the first 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months, respectively.

Conclusion: Between 48% and 64% of people remained on an asthma biologic for 6 months or more after first use. Most people who achieved a reduction in asthma exacerbations did so in the first 6 months of treatment.

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Conflict of interest statement

Conflict of Interest Statement: None of the authors reported a conflict of interest.

Figures

Figure 1:
Figure 1:
Cohort Selection Flow for Aggregate Asthma Biologic Analyses
Figure 2:
Figure 2:
Aggregate Persistence of Asthma Biologic Use: A Time-To-Stopping Analysis
Figure 3:
Figure 3:
Persistence of Individual Asthma Biologic Use: A Time-To-Stopping Analysis
Figure 4:
Figure 4:. Time-to-achieve a 50% Reduction in Asthma Exacerbations After Starting an Asthma Biologic
The blue line represents the time-to-achieve a clinical response for people who had medical and pharmacy coverage during the specified 6 month period. The upper and lower limit lines represent estimates that include people who were lost to follow-up; the upper line assumes all people lost to follow-up achieved a clinical response and the lower line assumes none of the people lost to follow-up achieved a clinical response.
Figure 5:
Figure 5:
Time on Treatment by Clinical Response to Biologics
See this image and copyright information in PMC

References

    1. Inselman JW, Jeffery JM, Maddux JT, et al. (2019). “Trends and Disparities in Asthma Biologic Use in the United States.” J Allergy Clin Immunol Pract 8(2): 549–554 e541. - PMC - PubMed
    1. Li P, Kavati A, Puckett JT, et al. (2020). “Omalizumab Treatment Patterns Among Patients with Asthma in the US Medicare Population.” J Allergy Clin Immunol Pract 8(2): 507–515.e510. - PubMed
    1. Ke X, Kavati A, Wertz D, et al. (2018). “Real-world Clinical Characteristics, Treatment Patterns, and Exacerbations in US Patients with Asthma Newly Treated with Omalizumab.” Clin Ther_40(7): 1140–1158.e1144. - PubMed
    1. Rabe KF (2019). “New Biologics for Severe Asthma: What Patients, What Agents, What Results, at What Cost?” Am J Respir Crit Care Med 199(4): 406–408. - PubMed
    1. Ledford D, Busse W, Trzaskoma B, et al. (2017). “A randomized multicenter study evaluating Xolair persistence of response after long-term therapy.” J Allergy Clin Immunol 140(1): 162–169.e162. - PubMed

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