The real world effect of omalizumab add on therapy for patients with moderate to severe allergic asthma: The ASTERIX Observational study

PLoS One. 2017 Aug 31;12(8):e0183869. doi: 10.1371/journal.pone.0183869. eCollection 2017.

Abstract

Background: Omalizumab is a non-steroidal medication indicated for the treatment of poorly controlled moderate-to-severe allergic asthmatics. This observational study examines the "real world" effectiveness of omalizumab in this population.

Methods: This is a one year open-label observational study that compared clinical outcomes including total oral corticosteroid use, exacerbation history, measures of quality of life and inflammation in patients with moderate-to-severe allergic asthma, who were prescribed omalizumab as part of their treatment with the year prior to therapy.

Results: A total of 99 patients were enrolled at 25 sites in Canada. During the study period, the mean total annual OCS dose was reduced from 2301.5 mg (prednisone equivalents) in the year prior to omalizumab to 1130.0 mg (p<0.0001). There was a 71% reduction in asthma exacerbations and 56% of patients on omalizumab remained exacerbation free when compared to the year prior to study entry. Associated with this was reduced health care utilization. There were significant improvements in the Asthma Control Questionnaire (ACQ) and Asthma Quality of Life questionnaire (AQLQ) Patients with an elevated FeNO at baseline showed a better response to treatment. No new safety issues were identified during the study period.

Conclusion: Our study demonstrates that in "real world" clinical practice, after initiating omalizumab, there is a reduction in total OCS use and exacerbation frequency in patients with moderate-to-severe allergic asthma. Patients on treatment reported improved asthma control and quality of life. FeNO may be a useful biomarker to identify patients who may benefit with omalizumab treatment.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / metabolism
  • Asthma / physiopathology
  • Asthma / psychology
  • Biomarkers / metabolism
  • Disease Progression
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Exhalation
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Nitric Oxide / metabolism
  • Omalizumab / therapeutic use*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prednisone / therapeutic use
  • Quality of Life / psychology*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Anti-Asthmatic Agents
  • Biomarkers
  • Glucocorticoids
  • Omalizumab
  • Nitric Oxide
  • Prednisone

Grants and funding

MB, WHY and JH received honoraria as part of the steering committee for the development of the research protocol. MB, WHY and JH are members of Novartis Advisory Boards. Novartis Pharmaceuticals Canada Inc. provided funding for the development and implementation of this observational study. This included support for the individual sites to collect data for the duration of the study. They also funded the analysis of the study. No study medication was funded by Novartis as this was an observational trial only. Study medication was supplied through public and private payers, as the patients enrolled in the study met the Canadian product monograph for the utilization of omalizumab in the severe asthma population.