Real-life cost-effectiveness of benralizumab in patients with severe asthma.

BACKGROUND: Availability of clinically effective and cost-effective treatments for severe asthma would be beneficial to patients and national healthcare systems. The aim of this study was to evaluate clinical outcomes and healthcare expenditure after incorporating benralizumab into the standard treatment of refractory eosinophilic asthma. METHODS: This was a cross-sectional multicentre study of consecutive patients with refractory eosinophilic asthma who received treatment with benralizumab during at least 12 months. Patient follow-up was performed in specialised severe asthma units. The main effectiveness parameters measured were: the avoidance of one asthma exacerbation, a 3-point increase in the asthma control test (ACT) score, and the difference in utility scores (health-related quality of life) between a 1-year baseline treatment and 1-year benralizumab treatment. The health economic evaluation included direct costs and incremental cost-effectiveness ratios (ICERs). RESULTS: After 1 year of treatment with benralizumab, patients with refractory eosinophilic asthma showed an improvement in all the effectiveness parameters analysed: improvement of asthma control and lung function, and decrease in the number of exacerbations, oral corticosteroid (both as corticosteroid courses and maintenance therapy), and inhaled corticosteroid use. The total annual cost per patient for the baseline and benralizumab treatment periods were €11,544 and €14,043, respectively, reflecting an increase in costs due to the price of the biological agent but a decrease in costs for the remaining parameters. The ICER was €602 per avoided exacerbation and €983.86 for every 3-point increase in the ACT score. CONCLUSIONS: All the pharmacoeconomic parameters analysed show that treatment with benralizumab is a cost-effective option as an add-on therapy in patients with refractory eosinophilic asthma.

Real-life experience with benralizumab during 6 months.

BACKGROUND: Benralizumab is a monoclonal antibody that binds to the human interleukin-5 (IL-5) receptor (IL-5R), thereby preventing IL-5 from binding to its receptor and inhibiting differentiation and maturation of eosinophils in the bone marrow. Because of its recent marketing approval, sufficient real-life evidence is lacking to confirm the efficacy and safety data from clinical trials. The purpose of this study was to evaluate the efficacy and safety of benralizumab for the treatment of severe refractory eosinophilic asthma in a real-world cohort of patients. METHODS: This was a cross-sectional multicentre study of consecutive patients with severe refractory eosinophilic asthma who received treatment with benralizumab during at least 6 months. Patient follow-up was performed in specialised severe asthma units. RESULTS: A total of 42 patients were enrolled and treated with benralizumab. Asthma control, as measured by the asthma control test (ACT), improved in all patients both at 3 months of treatment compared with baseline (13.9 ± 4 vs 20.1 ± 3.7, p < 0.001) and at 6 months of treatment compared with the results obtained at 3 months (20.1 ± 3.7 vs 21 ± 2.7, p = 0.037). Similarly, the number of emergency department visits decreased both at 3 months compared with baseline (1 [IR:0.7] vs 0 [IR:0.75], p < 0.001) and at 6 months compared with the results at 3 months (0 [IR:0.75] vs 0 [IR:0], p = 0.012). Reductions in the number of oral corticosteroid cycles, percentage of corticosteroid-dependent patients, and mean daily dose of oral or inhaled corticosteroid were also evidenced. Finally, mean lung function improvement was 291 mL (p < 0.001), and FEV1% improved both at 3 months compared with baseline (64.4 ± 9.3 vs 73.1 ± 9.1, p < 0.001) and at 6 months compared to 3 months (73.1 ± 9.1 vs 76.1 ± 12, p = 0.002). Side effects were mild and did not lead to treatment discontinuation. CONCLUSIONS: This study confirms the efficacy and safety of benralizumab in a real-life setting with improved asthma control and lung function, and a reduced oral and inhaled corticosteroid use as well as fewer emergency department visits. In addition to a rapid initial improvement, it appears that patients continue to improve during the first 6 months of treatment.

Tabaquismo y morbilidad psiquiátrica / Smoking habit and psychiatric morbidity

No disponible

Tabaquismo y asma / Smoking habit and asthma

No disponible

Determinantes de la capacidad de esfuerzo en pacientes adultos diagnosticados de fibrosis quística / Determining exertion capacity of adult cystic fibrosis patients

Introducción: La fibrosis quística (FQ) es una enfermedad hereditaria que se relaciona con un deterioro de la función pulmonar, malnutrición e intolerancia progresiva al ejercicio. La finalidad de nuestro estudio fue examinar la capacidad de esfuerzo de pacientes adultos diagnosticados de FQ y su relación con la función pulmonar, el estado nutricional y la actividad física. Método: Incluimos a 50 pacientes adultos diagnosticados de FQ, edad 24,4 (5,9) años con FEV1 60,4 (28)%. Las medidas incluyeron el índice de masa corporal (IMC), masa magra de extremidades (MMe), función pulmonar, evaluación de la capacidad de ejercicio (VO2max) y test de los 6 minutos (6MM). La actividad física fue medida mediante un acelerómetro portátil. Se calculó un modelo de regresión lineal múltiple para VO2max.Resultados: Los pacientes tenían un reducido IMC (20,6 (2,7) kg/m2) y MMe (17,2 (2,6) g/cm2). La distancia media andada en el 6MM fue 633,3 (74,5) m y el VO2max alcanzado fue 70,9 (17,7)%. La media de los pasos medios medidos fue 8.173,8 (3.776,2). La VO2max se relacionaba de forma significativa con la edad (–0,3 (–0,561 / –0,061), FEV1 (0,117; 0,059-0,175), media de pasos diarios (0,001 [0-0,001]), 6MM (0,022[0-0,045]) e IMC (–0,658[–1,2 / –0,067]). Conclusiones: En nuestro grupo de pacientes con FQ, había limitación en la realización de ejercicio, estando ésta influenciada por la función respiratoria, la actividad física y el estado nutriciona (AU)

Introduction: Cystic fibrosis (CF) is a hereditary disease linked to the deterioration of lung function, malnutrition and progressive exercise intolerance. The objective of this study was to examine the exertion capacity of CF patients and the relationship with lung function, nutritional status and physical activity. Method: Included in the study were fifty (50) patients who had been diagnosed with CF, age 24.4 (±5.9 years with FEV160.4 (28%). Measurements included body mass index (BMI), limb lean mass (LLM), lung function, assessment of exercise capacity (VO2 max) and 6-minute walk test. Physical activity was measured using a portable accelerometer. A multiple lineal regression model was calculated for VO2 max. Results: Patients had a reduced BMI (20.6 (±2.7) kg/m2) and LLM (17.2 (±2.6) g/cm2). The mean distance walked for the 6-minute walk was 633.3 (±74.5) m and the VO2 max reached was 70.9% (±17.7) The mean of the average steps measured was 8,173.8 (3,776.2). The VO2 max related significantly with the age (–0.3 (–0.561 / –0.061), FEV1 (0.117; 0.059-0.175), average of daily steps (0.001 [0-0.001]), 6-minute walk (0.022[0-0.045]) and BMI (–0.658[–1.2 / –0.067]). Conclusions: In our group of patients with CF, there were limits when exercising, with exercise being influenced by respiratory function, physical activity and nutritional status (AU)

Modificación del índice BODE tras un programa de entrenamiento al ejercicio frente a ventilación mecánica no invasiva en EPOC estable e insuficiencia respiratoria hipercápnica / BODE index modification after an exercise training programme versus non-invasive mechanical ventilation in stable COPD and hypercapnic respiratory insufficiency

Objetivos: El objetivo de nuestro trabajo fue analizar los beneficios de un programa de entrenamiento al ejercicio y la instauración de ventilación mecánica no invasiva (VMNI) en pacientes EPOC severos en situación de insuficiencia respiratoria hipercápnica. Materiales y Métodos (..) (AU)

Objectives: The aim of our study was to analyse the benefits of an exercise training programme and the introduction of non-invasive mechanical ventilation (NIMV) in patients with severe COPD (..) (AU)