Omalizumab evaluation of use in a pneumology service

• Autores: Silvia Cornejo Uixeda, Agustín Sánchez Alcaraz
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 18, Nº. 4, 2016, págs. 239-243
• Idioma: inglés
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• Resumen

  • Introduction: Severe asthma affects between 5% and 10% asthmatics. Despite high doses of drugs, the disease can turn into uncontrolled for these patients, who present frequent and severe exacerbations and have had any hospitalization episode related to this pathology during the last year. In addition, they present limited ventilation, defined as Forced Expiratory Volume (FEV₁) below 80%. Omalizumab is a drug indicated in fifth and sixth steps in severe persistent asthma. Due to its restricted use criteria and the elevated cost, we decided to evaluate the degree of compliance recommended criteria specified in its summary of product characteristics.

    Methods: This is a retrospective, observational study of patients who were treated with omalizumab from January to October 2015. Registered data were: age, sex, diagnosis, weight, baseline IgE, FEV₁, dose, administration periodicity, start date and if asthma was controlled. Afterwards, some treatment changes were submitted to the Pneumology Service for their evaluation to make them match the criteria of use.

    Results: 50 patients were included in the study. 60% of the patients did not meet the criteria. After the initial evaluation and a meeting with the Pneumology Service, 19 treatments were suspended due to inefficacy, 26 were maintained although three of them had the posology changed. Despite unfulfilling the criteria of use, the remaining five patients treatments were being effective and therefore, as required by law, a special situation medication form was requested. The suppression of the 19 treatments means an estimated annual saving of €276,900.

    Discussion: This evaluation shows an effectiveness of omalizumab in 54% of patients. Ineffective treatments on patients were maintained for an average of 33.7 months before they were evaluated. This makes us consider the necessity of evaluate periodically the effectiveness