Omalizumab exposure patterns in real-life: An 11-year French population-based study of 19,203 patients with severe asthma

Abstract

Background: The real-life effectiveness of omalizumab (OMA) has been widely studied since it was commercialized 15 years ago but exposure patterns and factors of persistence remain to be explored, particularly in children.

Aims and objectives: To describe patient characteristics and treatment exposure patterns of patients initiating OMA for severe asthma in France, and factors associated with persistence before long-term discontinuation (≥1 year).

Methods: The French administrative healthcare database (SNDS) was used to identify asthma patients aged ≥6 years who were prescribed OMA for at least 16 weeks from Jan 2009-Dec 2019. We examined OMA treatment patterns using Continuous Measures for Medication Acquisition (CMA), Kaplan-Meier, and Cox models (stepwise analysis).

Results: We identified 19,203 OMA initiations during the study period: 2,453 children and 16,750 adults. The mean [SD] age was 47.7 [19.9] years and 59.0% were female. Around 50% of the adults discontinued OMA before 54 months, with a Medication Possession Ratio of 93.4 [11.0] %. The probability of persistence at 2 years was 0.66 [95%CI: 0.65;0.67]. Trends observed in children were similar. Persistence in adults was associated with year of initiation and age, comorbidity of interest and use of antihistamines. In children, persistence was associated with a history of hospitalization for exacerbation, cumulative dose of oral corticosteroids, and use of antihistamines.

Conclusion: This French population study in 19,203 patients describes a long-term persistence of OMA treatment and highlights factors associated to its persistance.