Omalizumab versus 'Usual Care': Results from a Naturalistic Longitudinal Study in Routine Care
International Archives of Allergy and Immunology,  Clinical Article

Wittchen HU et al. – Substantial beneficial effects of omalizumab, similar to those observed in controlled trials and after marketing studies, were confirmed, particularly with regard to the reduction of asthma attacks, persistence of symptoms, asthma control and reduction of concomitant asthma medications. This study provides a tougher test and generalizable evidence for the effectiveness of omalizumab in routine care.

Methods
  • New–onset omalizumab–treated (OT) patients with SAA (n = 53) were compared to a matched control group of usual–care (UC) patients (n = 53).
  • Treatment and procedures were naturalistic.
  • Subsequent to a baseline assessment, patients were followed up over at least 6 months with at least two follow–up assessments.
  • Primary clinical outcomes were the number of asthma attacks, persistence of asthma symptoms and degree of control [asthma control test (ACT), Global Initiative for Asthma].
  • Secondary outcome criteria were quality of life (Euro–Qol 5D) and number of medications.
  • For each outcome the authors compared within–group effects from baseline to 6–month follow–up as well as between–group effects.

Results
  • OT patients showed significant improvements in number [effect size (ES) = 0.03] and frequency (ES = 0.04) of asthma attacks as well as asthma control (ES = 0.09), whereas controls revealed no significant improvements in these measures.
  • Further improvements in the OT group were found for ‘perceived control always’ (ACT, p = 0.006), no impairment (ACT, p = 0.02), reduction of sickness days (p = 0.002) and number of medications needed (p = 0.001).

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