Kathleen Y. Wang

BOSTON — Even if children are not fully adherent to treatment, those receiving omalizumab for the management of asthma have a significantly decreased risk of exacerbation, ED visits, hospitalizations and steroid use, according to a recent presentation at the American College of Allergy, Asthma and Immunology’s Annual Scientific Meeting.

“Similar to adherence to medications used in other chronic diseases, adherence to omalizumab, an injection administered every 2 or 4 weeks for inadequately controlled moderate to severe allergic asthma, varies,” Kathleen Y. Wang, MD, from the Children’s Hospital of Philadelphia, told Infectious Diseases in Children.

To evaluate how adherence to omalizumab affects asthma outcomes in children, the researchers conducted a retrospective chart review that included 49 children between the ages of 6 and 18 years who were administered omalizumab between January 2008 and December 2016. All received the drug for 52 weeks, and an asthma control test was administered to measure baseline and 52 weeks after starting omalizumab.

Additionally, Wang and colleagues also recorded the number of exacerbations experienced in this cohort during the study period. Data collected were compared in relation to adherence to treatment, which was defined as receiving at least 80% of the scheduled injections.

Those who participated in the study had a mean age of 12 ± 2.9 years, and 52% were male. Adherence, as defined by the researchers, was maintained by 77% of children (range: 45%-100%). Children who were administered omalizumab every 4 weeks were more likely to be adherent than those who received the drug every 2 weeks (83% vs. 74%; P = .16). A decrease was observed in exacerbations (38%), ED visits (69%), hospitalizations (75%) and steroid courses (59%) after completing 52 weeks of treatment (P <.05).

Regardless of level of adherence, similar changes in number of exacerbations, ED visits, hospitalizations, steroid courses, and asthma control score at 52 weeks were observed for all children. Treatment was considered to have failed in those who had asthma control scores that did not increase by at least 2 (16%). No significant difference was observed between adherent and nonadherent children in relation to failure of treatment.

“Corroborating previously published studies, omalizumab improves asthma-related outcomes such as flares, steroid courses, ED visits and hospitalizations in our pediatric study population,” she said in an interview. “Furthermore, we found no difference in measures of risk and impairment between adherent and non-adherent patients, advocating for its use even in patients with a history of medication non-adherence.” –by Katherine Bortz

Reference:

Wang K, et al. P239. Omalizumab remains efficacious in a pediatric population with asthma despite variable adherence. Presented at: The ACAAI Annual Meeting; Oct. 26-30, 2017; Boston, MA.

Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.