Omalizumab in the treatment of asthma: a long-term study

A real-life study conducted between 2009 and 2019 in France, describes asthma control and healthcare resource utilization when initiating and stopping omalizumab in adult asthma patients and pediatrics. In this review of asthma treatment with omalizumab, published in the European Respiratory Journal,1 the authors highlight remaining questions about the optimal duration of treatment in patients with severe asthma. While some studies show that most patients retain control of their asthma after stopping omalizumab, others show loss of control.2-4 Read: Respiratory infections in early life may increase risk of future disease Methadology The study population included beneficiaries available in the SNDS, aged six years and over and having initiated treatment with omalizumab for at least 16 weeks between January 2009 and December 2019. Treatment persistence, defined as the duration between T0 (date corresponding at first drug dispensation) and first long-term discontinuation, URS markers of asthma (exacerbations), as well as the Medication Possession Ratio (MPR), as an indicator of adherence, were considered in the to analyse; a RPM > 80% indicated treatment adherence. Principle results A total of 19,203 patients (16,750 adults and 2,453 children) initiated treatment with omalizumab. The mean (± standard deviation) overall follow-up period was 59.4 ± 37.9 months in adults and 57.9 ± 36.6 months in children. Read: Canadian screening tool could better predict asthma in children: JAMA study The median persistence of treatment before its interruption was 51.2 months (95% CI: 49.3 – 53.4) in adults and 53.7 months (95% CI: 50.6 – 56.4 ) in children. After two years of treatment with omalizumab, the rate of hospitalization for asthma decreased by approximately 75% and the use of oral corticosteroids (OCS) by 30%, in both adults and children. Among adults who stopped omalizumab when asthma was controlled, 70%, 39%, and 24% remained controlled and did not restart the drug one, two and three years after stopping, respectively. Among children, these proportions were higher (76%, 44% and 33% respectively). During the two years of follow-up after discontinuation, the URS remained stable in adults and children, especially for the rate of hospitalization for asthma and the use of OCS. In closing, this study is the first real-life report to have assessed asthma control upon discontinuation, and persistence of control after discontinuation, in a large cohort of adult and pediatric patients over a long period of time. follow-up period. Although the asthma control rates are based solely on the URS, they confirm the large percentage of patients who remained controlled as reported in a previous study.5 References 1. Humbert, M. et al. (2022). Real-life omalizumab exposure and discontinuation in a large nationwide population-based study of pediatric and adult asthma patients. Eur Respir J 60, 2103130. 2. Deschildre, A. et al. (2019). Omalizumab discontinuation in children with severe allergic asthma: an observational real-life study. Allergy 74, 999–1003. 3. Nopp, A. et al. (2010). After 6 years with Xolair; a 3-year withdrawal follow-up. Allergy 65, 56–60. 4. Molimard, M. et al. (2014). Observational study in severe asthmatic patients after discontinuation of omalizumab for good asthma control. RespirMed 108, 571–576. 5. Ledford, D. et al. (2017). A randomized multicenter study evaluating Xolair persistence of response after long-term therapy. J Allergy Clin Immunol 140, 162–169. This article has been translated from its original French and originally appeared on our sister site Profession Santé. Read: New Brunswick Liberals call for increased respiratory illness reporting

Omalizumab in the treatment of asthma: a long-term study

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