Analysis of questionnaire survey to determine worldwide trends in prescriptions of biologics for the treatment of unresponsive chronic urticaria.

Adverse effects Alternative therapy Biologics Chronic spontaneous urticaria Clinical research Epidemiology H1-antihistamines Monitoring Practice management Safety

Journal

The World Allergy Organization journal
ISSN: 1939-4551
Titre abrégé: World Allergy Organ J
Pays: United States
ID NLM: 101481283

Informations de publication

Date de publication:
Jan 2024
Historique:
received: 02 08 2023
revised: 04 12 2023
accepted: 09 12 2023
medline: 18 1 2024
pubmed: 18 1 2024
entrez: 18 1 2024
Statut: epublish

Résumé

Chronic spontaneous urticaria (CSU) is a common condition treated by allergist/immunologists, but the only FDA-approved biologic medication, omalizumab, may be underutilized globally. This study was performed to determine the global prescription of omalizumab for treatment of CSU by allergists/immunologists. Anonymous questionnaire surveys were distributed online to World Allergy Organization (WAO) members worldwide. Categorical data were analyzed for descriptive analysis using one-way frequency tabulation in SAS 9.4. There were 348 respondents (43 missing data); Average age 51 (range 28-90); M/F 48%/52%. 58% had > 15 years of clinical experience and 10% < 5; 42% worked in private clinics, 36% public hospitals, 24% academia, 18% private hospitals, and 4% in community practice. Eighty-two percent (82%) prescribed omalizumab for CSU patients and use of omalizumab was highest among young practitioners. The most significant barriers were cost (63%) and restricted formulary (24%). Drug safety (63%) and chances of adverse events (47%) were the most significant factors deciding treatment. Twenty-two percent (22%) reported 80-100% of CSU patients were complete responders to omalizumab; 34% preferred increasing frequency (q 2-weeks), and 18% preferred increasing dose (600 mg q 4-weeks) for partial or non-responders. UAS7, UCT, and CU-QoL were used to assess CSU by 55%, 29%, and 25% of respondents, respectively. Autoimmune thyroid disease (62%), thyroid abnormality (43%) and allergic rhinitis (35%) were the most frequent comorbidities reported. Most clinicians favored omalizumab over other potential treatments due to safety. Although younger clinicians were more likely to prescribe omalizumab, cost and formulary access were major barriers. Only 22% of respondents reported 80% or greater of their patients had complete response to omalizumab, indicating the need for novel CSU therapies.

Sections du résumé

Background UNASSIGNED
Chronic spontaneous urticaria (CSU) is a common condition treated by allergist/immunologists, but the only FDA-approved biologic medication, omalizumab, may be underutilized globally.
Objective UNASSIGNED
This study was performed to determine the global prescription of omalizumab for treatment of CSU by allergists/immunologists.
Methods UNASSIGNED
Anonymous questionnaire surveys were distributed online to World Allergy Organization (WAO) members worldwide. Categorical data were analyzed for descriptive analysis using one-way frequency tabulation in SAS 9.4.
Results UNASSIGNED
There were 348 respondents (43 missing data); Average age 51 (range 28-90); M/F 48%/52%. 58% had > 15 years of clinical experience and 10% < 5; 42% worked in private clinics, 36% public hospitals, 24% academia, 18% private hospitals, and 4% in community practice. Eighty-two percent (82%) prescribed omalizumab for CSU patients and use of omalizumab was highest among young practitioners. The most significant barriers were cost (63%) and restricted formulary (24%). Drug safety (63%) and chances of adverse events (47%) were the most significant factors deciding treatment. Twenty-two percent (22%) reported 80-100% of CSU patients were complete responders to omalizumab; 34% preferred increasing frequency (q 2-weeks), and 18% preferred increasing dose (600 mg q 4-weeks) for partial or non-responders. UAS7, UCT, and CU-QoL were used to assess CSU by 55%, 29%, and 25% of respondents, respectively. Autoimmune thyroid disease (62%), thyroid abnormality (43%) and allergic rhinitis (35%) were the most frequent comorbidities reported.
Conclusions UNASSIGNED
Most clinicians favored omalizumab over other potential treatments due to safety. Although younger clinicians were more likely to prescribe omalizumab, cost and formulary access were major barriers. Only 22% of respondents reported 80% or greater of their patients had complete response to omalizumab, indicating the need for novel CSU therapies.

Identifiants

pubmed: 38235261
doi: 10.1016/j.waojou.2023.100858
pii: S1939-4551(23)00118-7
pmc: PMC10793168
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100858

Informations de copyright

© 2023 The Authors.

Auteurs

Christine J Rubeiz (CJ)

Cincinnati Children's Hospital Medical Center, Division of Allergy and Immunology, Cincinnati, OH, USA.

Ricardo Asero (R)

Ambulatorio di Allergologia, Clinica San Carlo, Pademo Dugnano, Italy.

Stephen Betschel (S)

Unity Health, St Michael's Hospital, University of Toronto, Ontario, Canada.

Timothy Craig (T)

Pediatrics and Biomedical Sciences, Penn State University, Hershey, PA, USA.

Anete Grumach (A)

Centro Universitário Faculdade de Medicina ABC, Brazil.

Michihiro Hide (M)

Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.

David Lang (D)

Cleveland Clinic Lerner College of Medicine, Department of Allergy and Clinical Immunology, Cleveland, OH, USA.

Michael Levin (M)

University of Cape Town, South Africa.

Hilary Longhurst (H)

Department of Medicine, University of Auckland, Te Toka Tumai, New Zealand.
Department of Immunology, Auckland City Hospital, Te Toka Tumai, New Zealand.

Eli Magan (E)

Assuta Ashdod University Medical Center, Ben Gurion University of the Negev, Israel.

Marcus Maurer (M)

Charité and Fraunhofer, Berlin, Germany.

Romi Saini (R)

Johns Hopkins University School of Medicine, USA.

Gordon Sussman (G)

University of Ontario, Canada.

Elias Toubi (E)

University of Haifa, Israel.

Dinh Nguyen Van (DN)

Vinmec Health Care System, China.
College of Health Sciences, Vin University, China.
Department of Medicine, College of Medicine, Penn State University, USA.

Torsten Zuberier (T)

Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Institute of Allergology, Berlin, Germany.
Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany.

Jonathan A Bernstein (JA)

Cincinnati Children's Hospital Medical Center, Division of Allergy and Immunology, Cincinnati, OH, USA.
University of Cincinnati College of Medicine, Department of Internal Medicine, Division of Rheumatology, Allergy and Immunology, Cincinnati, OH, USA.

Classifications MeSH