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RESEARCH PRODUCT
Eligibility for treatment with omalizumab in Italy and Germany.
Roland BuhlDaniel CohenAndrea Gili MarcoGiorgio Walter Canonicasubject
Pulmonary and Respiratory Medicinemedicine.medical_specialtyPediatricsReferralEpidemiologySevere asthmaAllergic asthmaEligibility DeterminationOmalizumabPrimary careOmalizumabAntibodies Monoclonal HumanizedSeverity of Illness IndexAntibodiesSampling StudiesDose-Response RelationshipProduct LabelGermanyEpidemiologyMonoclonalmedicinePrevalenceHumansNational levelAnti-Asthmatic AgentsHumanizedAnti-immunoglobulin EEligibilityDose-Response Relationship Drugbusiness.industryPatient SelectionAllergic asthmaImmunoglobulin EAsthmaAntibodies Anti-IdiotypicAnti-IdiotypicTreatment OutcomeItalyQuality of LifeBiological MarkersDrugbusinessBiomarkersmedicine.drugAllergic asthma; Anti-immunoglobulin E; Eligibility; Epidemiology; Anti-Asthmatic Agents; Antibodies Anti-Idiotypic; Antibodies Monoclonal Humanized; Asthma; Biological Markers; Dose-Response Relationship Drug; Eligibility Determination; Germany; Humans; Immunoglobulin E; Italy; Patient Selection; Prevalence; Quality of Life; Sampling Studies; Severity of Illness Index; Treatment Outcomedescription
Summary Omalizumab is an add-on therapy for patients with uncontrolled severe allergic asthma. In Europe, patients must fulfil a number of additional criteria to become eligible for omalizumab therapy, creating a challenge for epidemiology studies to quantify the potential patient pool. Thus, and in the absence of robust data, the number of omalizumab-eligible patients has remained unclear. To assess eligible patient numbers, a chart-audit design approach was employed to measure epidemiology variables based on patient-level data. 770 patient charts were reviewed in designated towns in Germany and Italy, in collaboration with >200 primary care physicians (PCPs) and respiratory specialists (RS). This study sample represents >50% and >70% of local RS in these designated towns of Germany and Italy, respectively. Of patient charts evaluated, 4 patients were currently receiving omalizumab. A further 31 patients (12 PCP; 19 RS) were evaluated as omalizumab-eligible (i.e. fulfilled all product label criteria) but were not receiving the drug. Extrapolating to a national level, this yields >6500 eligible patients in Germany, and >3200 in Italy. Furthermore, this study sample revealed a significant number of PCPs treating uncontrolled severe asthma patients without referral to RS; these patients are not consistently evaluated for FEV 1 , aero-allergen sensitivity, a qualitative understanding of severe exacerbations, and day and night-time symptoms. This study suggests that significant numbers of omalizumab-naive severe allergic asthma patients in Germany/Italy are eligible for omalizumab therapy. Despite proven benefits in uncontrolled severe allergic asthma, adjunctive omalizumab therapy is underutilized.
year | journal | country | edition | language |
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2013-07-11 | Respiratory medicine |