Patients with hereditary angioedema visit the hospital less often with berotralstat
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Key takeaways:
- All-cause hospitalizations fell by 34%, and all-cause ED and outpatient visits fell by 14%.
- Patients with previous long-term prophylaxis use saw a 54% decrease in hospitalizations.
Patients with hereditary angioedema experienced fewer hospitalizations and ED and outpatient visits after beginning prophylactic treatment with berotralstat, according to a poster presented at a recent conference.
These results were consistent regardless of previous long-term prophylactic treatment, researchers reported at the International Society for Pharmacoeconomics and Outcomes Research 2024 annual conference.
“We wanted to assess how the beneficial impact of berotralstat on [hereditary angioedema (HAE)] disease control translates into real-world health care resource utilization,” Sandra Nestler-Parr, MSc, MPhil, vice president, value and access, BioCryst Pharmaceuticals, told Healio.
“In order to ensure objective, reliable results, we conducted a methodologically rigorous real-world study, using one of the largest U.S. claims databases,” Nestler-Parr said.
Study population
The study included 260 patients (mean age, 39.7 years; 74.2% female) aged 12 years and older who had one or more dispensations of berotralstat (Orladeyo, BioCryst) between Dec. 3, 2020, and Dec. 31, 2022, in Komodo’s Healthcare Map.
These patients included 53.8% with commercial insurance, 21.5% with Medicaid and 5.8% with Medicare. Also, 68.1% were treated by an allergist/immunologist and 11.9% were treated by their primary care provider at the index date.
The patients additionally included 51.5% who had not received any previous long-term prophylaxis (LTP), including 25.8% who had used on-demand treatment.
Mean follow-up durations included 12 months for the overall cohort, 13 months for those with LTP experience (n = 126) and 13 months for those with no LTP experience but who had used on-demand treatment (n = 67).
Fifty percent of the patients reported swelling, edema or breathing difficulties and 37% reported pain at baseline, with 18% reporting food or drug allergy or hypersensitivity reactions and 13% reporting urticaria.
Additionally, at baseline, 46% reported at least one dispensation or administration of glucocorticoids, antihistamines, epinephrine or omalizumab (Xolair; Genentech, Novartis).
Resource utilization
Records indicated a 34% decrease in all-cause hospitalizations and a 14% decrease in all-cause outpatient and ED visits after patients began using berotralstat.
Hospitalizations related to angioedema fell by 52% and outpatient and ED visits related to angioedema fell by 44% after berotralstat initiation.
Among the patients with LTP experience, there was a 54% decrease in hospitalizations and a 37% decrease in outpatient and ED visits, both related to angioedema, after treatment with berotralstat began.
The patients who had no LTP experience but who did have on-demand treatment experienced a 62% decrease in hospitalizations and a 45% decrease in outpatient and ED visits after beginning berotralstat.
The researchers classified all these decreases as significant.
“I was impressed by the influence of prescribing berotralstat upon the all-cause health care resource utilization. The magnitude of the change proved to be significant even within the limited timeframe of the study,” Sandra C. Christiansen, MD, director of translational research at the U.S. HAEA Angioedema Center, University of California, San Diego, told Healio.
“This finding can reasonably be interpreted as a surrogate for improved HAE disease control. The outcomes of our study have important implications for the role of berotralstat as a cost-effective prophylactic therapy for the management of HAE,” Christiansen said.
The reduction in required hospital visits for these patients also translates into another advance toward the goal of leading a normal life, she added.
However, the researchers cautioned that the claims data that provided this information may be vulnerable to inaccuracies and that records of dispensed medication do not mean the medication was consumed or taken as prescribed. Also, the data did not include over-the-counter medications.
Yet the researchers concluded, based on these findings, that the initiation of berotralstat for patients with HAE was associated with decreased health care resource use whether or not patients had previously used LTP.
“In addition to overall and angioedema-related health care resource utilization, we also studied the impact of berotralstat on HAE attack-related health care resource utilization,” Nestler-Parr said. “We are excited about these results, which will be published in the near future.”
The researchers’ work will continue, she added.
“We will continue to study the benefits of berotralstat in the real world and further expand the body of evidence related to its positive impact on patients’ lives and the health care system,” Nestler-Parr said.
Reference:
- BioCryst presents new real-world evidence showing significant reductions in healthcare resource utilization among patients with HAE following initiation of Orladeyo (berotralstat). https://ir.biocryst.com/news-releases/news-release-details/biocryst-presents-new-real-world-evidence-showing-significant. Published May 9, 2024. Accessed May 9, 2024.