Biologic agents are linked to a decrease in pediatric asthma hospital admissions as well as a reduction in oral corticosteroid (OCS) use in children with asthma, according to study findings published in Pediatric Pulmonology.
Researchers assessed the effects of biologic treatment among children aged 6 to 11 years with asthma, using health care utilization databases in Lombardy, Italy. Patients who received at least 1 prescription of omalizumab, mepolizumab, or dupilumab from January 2017 to December 2021 were identified for inclusion in this analysis.
The main outcome was the use of anti‐asthmatic drugs other than biologics in the follow‐up period (ie, the year after the index date) vs the use of such drugs during the baseline period (ie, the year before the index date). The index date was defined as the date of first use of a biologic.
The analysis included 46 children (58.7% male; mean [SD] age, 9.1 [1.9] years). Omalizumab was the most commonly prescribed biologic agent (80.4%).
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[B]iologic drugs, namely omalizumab, mepolizumab, and dupilumab, markedly reduce OCS use and exacerbation‐related hospital and ER admissions in children with asthma, without affecting adherence to maintenance therapy (mainly ICS).
Researchers found that the number of patients requiring at least 1 OCS prescription was 45.2% less in the follow‐up period vs in the baseline period (67.4% vs 37%, P =.0035) and that the mean number of prescriptions in children also significantly decreased by 58.6% (2.9 vs 1.2; P <.0001).
The number of patients who received at least 1 prescription of anti‐asthmatic drugs other than biologic agents did not significantly change, with similar findings occurring for the antihistamine class. Among patients with at least 1 prescription of other respiratory drugs, the mean number of annual prescriptions was reduced from 9.9 to 7.1, P =.0033. The mean number of prescriptions of short‐acting beta agonists, reliever medications for asthma flare‐ups, and ICS + long‐acting beta agonists for treated patients decreased by about 40%.
The number of children who had at least 1 exacerbation‐related hospitalization decreased by 75.0% in the year after biologic treatment initiation compared with the baseline period (16 vs 4 patients, P =.0024), with the number of hospitalizations decreasing significantly (1.3 vs 0.5, P =.0178).
Among children who had at least 1 emergency room (ER) visit, hospital admission for respiratory diseases (85.7%) and nonrespiratory diseases (47.6%) decreased significantly from the baseline period to the follow‐up period. Within the first 6 months of treatment initiation with a biologic agent, 3 of 46 patients (6.5%) did not renew their prescription. Also, the mean overall health care costs increased from 6108.5 euros in the pre-index period to 15409.4 euros in the post-index period.
Among several limitations, hospital records were not available for review; the diagnostic validity of asthma could not be verified; data on comorbid conditions and other clinical factors were not available; and due to the small number of patients with prescriptions for mepolizumab and dupilumab, researchers were unable to conduct separate analyses for each biologic agent.
“Our findings suggest that biologic drugs, namely omalizumab, mepolizumab, and dupilumab, markedly reduce OCS use and exacerbation‐related hospital and ER admissions in children with asthma, without affecting adherence to maintenance therapy (mainly ICS),” the researchers stated.
Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
