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Lourenço J, Vaz AP, Fernandes RA, Lopes C, Fernandes AL. Evaluation of patients' satisfaction with domiciliary biological treatment in severe asthma: a Portuguese survey. Monaldi Arch Chest Dis 2024. [PMID: 38516875 DOI: 10.4081/monaldi.2024.2865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
Dear Editor, According to GINA, severe asthma is defined as uncontrolled asthma, despite therapy adherence with an optimized high dose of inhaled corticosteroid plus long-acting ß2-agonist coupled with management of modifiable factors/comorbidities, that worsens when this treatment is decreased. It affects a significant portion of asthmatic patients and imposes a high risk of exacerbations and mortality, which are associated with significant healthcare costs and psychosocial impact...
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Affiliation(s)
- Joana Lourenço
- Pulmonology Department, Pedro Hispano Hospital, Matosinhos Local Health Unit, Oporto.
| | - Ana Paula Vaz
- Pulmonology Department, Pedro Hispano Hospital, Matosinhos Local Health Unit, Oporto.
| | - Rosa Anita Fernandes
- Immuno-allergology Unit, Pedro Hispano Hospital, Matosinhos Local Health Unit, Oporto.
| | - Cristina Lopes
- Immuno-allergology Unit, Pedro Hispano Hospital, Matosinhos Local Health Unit, Oporto.
| | - Ana Luísa Fernandes
- Pulmonology Department, Pedro Hispano Hospital, Matosinhos Local Health Unit, Oporto.
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Cisneros-Serrano C, Rial MJ, Gómez-Bastero-Fernández A, Igea JM, Martínez-Meca A, Fernández-Lisón LC, López-Carrasco V, Villamañán-Bueno E, Plá-Martí MJ, Chiner E. Spanish multidisciplinary consensus on the characteristics of severe asthma patients on biologic treatment who are candidates for at-home administration. Rev Clin Esp 2023; 223:154-164. [PMID: 36549642 DOI: 10.1016/j.rceng.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Biologic therapies are known to reduce exacerbations and improve severe uncontrolled asthma management. The at-home administration of biologics has increased during the COVID-19 pandemic, but the characteristics of severe uncontrolled asthma patients who may benefit from at-home administration of biologic therapy have yet to be identified. MATERIALS AND METHODS This project is based on the Delphi method, designed to reach an expert consensus through a multidisciplinary scientific committee addressing the following questions: clinical characteristics, treatment adherence, patient or caregiver administration ability, patient self-care, relationship with the healthcare professional, patient preference, and access to the hospital. RESULTS One hundred and thirty-one healthcare professionals (pulmonologists, allergists, nurses, and hospital pharmacists) completed two Delphi consensus questionnaires. Fourteen items were identified as priority characteristics, the first five being: 1. The patient follows the healthcare team's indications/recommendations to control their disease, 2. The patient is capable of detecting any deterioration in their disease and of identifying exacerbation triggers, 3. The patient receives biologic therapy and has stable disease with no vital risk, 4. The patient takes responsibility for their self-care, 5. The patient has occupational/educational obligations that prevent them from going to the hospital regularly. CONCLUSION Disease stability and control plus the ability to identify exacerbation triggers are the most important characteristics when opting for at-home administration for a patient with severe uncontrolled asthma on biologic therapy. These recommendations could be applicable in clinical practice.
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Affiliation(s)
- C Cisneros-Serrano
- Pulmonology Department, Hospital Universitario La Princesa, Madrid, Spain.
| | - M J Rial
- Allergy Department, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain
| | | | - J M Igea
- Clínica Alergoasma, Salamanca, Spain
| | - A Martínez-Meca
- Pulmonology Department Nurse, Hospital Universitario de La Princesa, Madrid, Spain
| | - L C Fernández-Lisón
- Hospital Pharmacy Department, Complejo Hospitalario Universitario de Cáceres, Cáceres, Spain
| | - V López-Carrasco
- Allergy Department Nurse, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | | | - M J Plá-Martí
- Allergy Department Nurse, Hospital Universitario La Fe, Valencia, Spain
| | - E Chiner
- Pulmonology Department, Hospital Universitario San Juan d'Alacant, Alicante, Spain
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3
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Cisneros-Serrano C, Rial M, Gómez-Bastero-Fernández A, Igea J, Martínez-Meca A, Fernández-Lisón L, López-Carrasco V, Villamañán-Bueno E, Plá-Martí M, Chiner E. Consenso multidisciplinar español sobre las características de los pacientes con asma grave en tratamiento con biológicos susceptibles de pasar a tratamiento domiciliario. Rev Clin Esp 2023. [DOI: 10.1016/j.rce.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Murphy KR, Winders T, Smith B, Millette L, Chipps BE. Identifying Patients for Self-Administration of Omalizumab. Adv Ther 2023; 40:19-24. [PMID: 36173511 PMCID: PMC9859916 DOI: 10.1007/s12325-022-02308-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/19/2022] [Indexed: 02/04/2023]
Abstract
Omalizumab, a recombinant anti-immunoglobulin E (IgE) monoclonal antibody, is indicated for moderate to severe allergic asthma, chronic spontaneous urticaria, and nasal polyps, and is approved for self-administration. However, specific guidance on identifying candidates with characteristics suitable for this type of administration is lacking. To help address this issue, this article provides practical considerations for the health care provider treating patients with omalizumab. We encourage health care providers to consider self-administration of omalizumab as an option for all appropriate, but not all, patients, and we recommend an individualized approach when considering self-administration of omalizumab.
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Affiliation(s)
| | - Tonya Winders
- Allergy and Asthma Network, Vienna, VA USA ,Global Allergy and Airways Patient Platform, Vienna, Austria
| | | | | | - Bradley E. Chipps
- Capital Allergy and Respiratory Disease Center, 5609 J Street, Suite C, Sacramento, CA 95819 USA
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Borrás-Blasco J, Vicente-Escrig E, Rodríguez-Lucena FJ, García-Monsalve A, Arroyo-Domingo E, Ferrando-Piqueres R, Casterá E, Navarro-Ruiz A. Six months multicentre pilot open label single-arm study to evaluate patient experience, acceptability and satisfaction of switching certolizumab pegol from a prefilled syringe or autoinjection pen to an AVA® e-Device in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis patients. J Clin Pharm Ther 2022; 47:2345-2349. [PMID: 36470844 DOI: 10.1111/jcpt.13820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 12/12/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The study aimed to assess acceptability and patient experience of Certolizumab (CZP) self-injection with AVA® and clarify patient device preference after switching CZP from the syringe or auto-injection pen to AVA® in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA) patients. METHOD A multicentre open-label, cross-sectional and prospective study among four Spanish hospitals was performed. Adult RA, PsA, axSpA patients treated for at least 6 months with the CZP syringe or pen were recruited. At the first visit, patients completed Pre-AVA® questionnaire. Patients were instructed on proper administration of CZP by AVA®. After 2 and 6 months of CZP self-injections using the AVA®, patient experience, adherence, preference and safety of each administration was assessed using post-AVA® questionnaire. RESULTS AND DISCUSSION Thirty four patients were included (28 women). All patients self-administered CZP AVA® the full dose of CZP was injected. Patients reported >90% adherence to CZP AVA® assessed with the injection log. Pain at the injection site was reduced after switching to AVA®. Twenty nine patients preferred CZP AVA® and five patients preferred the CZP pen. No safety-related findings related to AVA® CZP administration were identified. WHAT IS NEW AND CONCLUSION The AVA® is an advantageous delivery option for CZP in patients with RA, PsA, axSpA.
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Ong KY, Tiew PY, Koh MS. Managing adult asthma during the COVID-19 pandemic: A 2022 review and current recommendations. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022. [DOI: 10.47102/annals-acadmedsg.202285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: This review aims to examine asthma management during the COVID-19 pandemic.
Method: Relevant recommendations and articles were identified by respiratory professional societies and PubMed search using the terms “asthma” and “COVID-19”, and examined for relevance and inclusion in this study.
Results: Recommendations for the management of asthma have remained similar but are now supported by new evidence between the years 2020 and 2022. Patients with well-controlled, mild-to-moderate asthma are unlikely to be at increased risk of acquiring COVID-19 or having worse outcomes from COVID-19. All asthma patients should receive COVID-19 vaccination. Spirometry can be performed with the usual strict infection control procedures unless there is a suspicion of COVID-19. Mask-wearing and other health measures remain important for asthma patients.
Conclusion: While previous recommendations were largely based on expert opinion, the tremendous amount of literature published since the pandemic first emerged 2 years ago has helped guide respiratory professional bodies to update their recommendations. This study provides a timely review of the various recommendations and can be used to guide healthcare professionals in managing asthma patients, as the world prepares for a future with COVID-19 becoming endemic. The long-term consequences of COVID-19 infection in asthma patients and the ripple effects of COVID-19 remain uncertain and deserve ongoing study.
Keywords: Asthma, coronavirus, COVID-19, SARS-CoV-2
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Affiliation(s)
- Kheng Yong Ong
- Department of Pharmacy, Singapore General Hospital, Singapore
| | - Pei Yee Tiew
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
| | - Mariko Siyue Koh
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
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Alizadeh Bahmani AH, Abdel-Aziz MI, Maitland-van der Zee AH, Vijverberg SJH. Recent advances in the treatment of childhood asthma: a clinical pharmacology perspective. Expert Rev Clin Pharmacol 2022; 15:1165-1176. [PMID: 36196626 DOI: 10.1080/17512433.2022.2131537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Childhood asthma is a complex heterogenous inflammatory disease that can pose a large burden on patients and their caregivers. There is a strong need to adapt asthma treatment to the individual patient taking into account underlying inflammatory profiles, moving from a 'one size fits all' approach toward a much-needed personalized approach. AREAS COVERED This review article aims to provide an overview of recent advances in the management and treatment of pediatric asthma, including novel insights on the molecular heterogeneity of childhood asthma, the emergence of biologicals to treat severe asthma, and innovative e-health and home monitoring techniques to make asthma management more convenient and accessible. EXPERT OPINION Molecular technologies have provided new treatment leads. E-health and home monitoring technologies have helped to gain more insights into disease dynamics and improve adherence to treatment while bringing health care to the patient. However, uncontrolled childhood asthma is still a major unmet clinical need and precision-medicine approaches are still scarce in clinical practice. Advanced omics methods may help researchers or clinicians to more accurately phenotype and treat subtypes of childhood asthma and gain more insight into the complexity of the disease.
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Affiliation(s)
| | - Mahmoud I Abdel-Aziz
- Amsterdam UMC Location University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, The Netherlands.,Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut, Egypt
| | - Anke H Maitland-van der Zee
- Amsterdam UMC Location University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, The Netherlands.,Amsterdam UMC Location University of Amsterdam, Department of Paediatric Pulmonology, Amsterdam, The Netherlands
| | - Susanne J H Vijverberg
- Amsterdam UMC Location University of Amsterdam, Department of Pulmonary Medicine, Amsterdam, The Netherlands.,Amsterdam UMC Location University of Amsterdam, Department of Paediatric Pulmonology, Amsterdam, The Netherlands
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Flokstra-de Blok B, Kocks J, Wouters H, Arling C, Chatelier J, Douglass J, Heaney LG, Holmes J, Humbert M, Kolanowski M, Landsman JJA, Lugogo N, Malpass A, Meijer J, Metz B, de Mul B, Postma F, Leving M. Perceptions on Home-Administration of Biologics in the Context of Severe Asthma: An International Qualitative Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2312-2323.e2. [PMID: 35487370 DOI: 10.1016/j.jaip.2022.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Biologics are an effective therapy for severe asthma. Home administration of biologics by patients is likely to facilitate their accessibility. Yet little is known about patients' and health care providers' (HCPs) perceptions regarding home administration of biologics. OBJECTIVE The aim of this study is to create more insight into the perceptions and experiences of patients and HCPs regarding home administration of biologics in the context of the treatment of severe asthma. METHODS A qualitative international study was performed in the Netherlands, United States, Australia, and United Kingdom. In each country, 2 focus groups were held with potential/recent and long-term users of biologics at home. Prior to the focus groups, patients were prompted with themes on online forums. For triangulation purposes, interviews were held with HCPs to discuss salient findings from forums and focus groups. Data were analyzed with qualitative content analysis. RESULTS In total, 75 patients participated in the forums, of which 40 participated in the focus groups. Furthermore, 12 HCPs were interviewed. The following overarching themes were identified: living with severe asthma; practical aspects of using biologics; the role of HCPs regarding biologics; social support from family, friends, and others; effectiveness of biologics and other treatments; side effects of biologics. CONCLUSIONS This study showed that, for those using biologics for severe asthma, the benefits of home administration of biologics usually outweigh inconvenience and side effects. Guided practice, accessible support contact, and monitoring including social support should be central in the transition from hospital to home administration of asthma biologics.
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Affiliation(s)
- Bertine Flokstra-de Blok
- General Practitioners Research Institute, Groningen, The Netherlands; Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.
| | - Janwillem Kocks
- General Practitioners Research Institute, Groningen, The Netherlands; Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Observational and Pragmatic Research Institute, Singapore, Singapore; Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans Wouters
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Chantal Arling
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Josh Chatelier
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Jo Douglass
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Liam G Heaney
- Wellcome Wolfson Centre for Experimental Medicine, Queens University, Belfast, Northern Ireland
| | - Joshua Holmes
- Wellcome Wolfson Centre for Experimental Medicine, Queens University, Belfast, Northern Ireland
| | - Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, INSERM UMR_S 999, Assistance Publique - Hôpitaux de Paris, Department of Respiratory and Intensive Care Medicine, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Mary Kolanowski
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich
| | - Jeanet J A Landsman
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Njira Lugogo
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich
| | - Alice Malpass
- Bristol Medical School, Centre for Academic Primary Care (CAPC), University of Bristol, Bristol, UK
| | - Jiska Meijer
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Boyd Metz
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Bibicha de Mul
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Frank Postma
- General Practitioners Research Institute, Groningen, The Netherlands
| | - Marika Leving
- General Practitioners Research Institute, Groningen, The Netherlands
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Menzella F, Fontana M, Ruggiero P, Livrieri F, Facciolongo N. Home-based treatment of biologics for asthma: who, what, where, when and why. Expert Rev Respir Med 2022; 16:419-428. [PMID: 35324362 DOI: 10.1080/17476348.2022.2057301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The advent of biologic therapies for severe asthma has profoundly changed the management of this pathology. The introduction of home administration is therefore an important innovation to optimize the patients' management, even if there are many aspects that need to be clarified and pointed out. AREAS COVERED This review summarizes the path that led to the possibility of self-administration of biologics, and what the pandemic has changed in the management of these patients. EXPERT OPINION The growing understanding of asthma phenotypes and endotypes is enabling the careful selection of patients suitable for biologics. In this context, the availability of reliable and simple self-injection devices is important in implementing self-administration. The transition to self-injection is also possible thanks to the high safety profile of biologics. With attention, most patients may potentially be suitable for self-administration. The transition process from hospital to home administration can therefore be carried out correctly by clinicians with adequate expertise in the field of severe asthma and biologic therapies, with the support of other health professionals, pharmacists, and general practitioners. Home administration is probably the best way to guarantee high adherence and high-level satisfaction of patients, even in the long term.
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Affiliation(s)
- Francesco Menzella
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, 42123, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Matteo Fontana
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, 42123, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Patrizia Ruggiero
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, 42123, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Francesco Livrieri
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, 42123, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Nicola Facciolongo
- Pulmonology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, 42123, Via Amendola 2, 42122, Reggio Emilia, Italy
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Colello J, Ptasinski A, Zhan X, Kaur S, Craig T. Assessment of Patient Perspectives and Barriers to Self-Infusion of Augmentation Therapy for Alpha-1 Antitrypsin Deficiency During the COVID-19 Pandemic. Pulm Ther 2022; 8:95-103. [PMID: 35067906 PMCID: PMC8784277 DOI: 10.1007/s41030-022-00182-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/06/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Alpha-1 antitrypsin (AAT) deficiency is an autosomal co-dominant genetic condition that predisposes individuals to pulmonary and hepatic disease, and in severe cases is treated with augmentation by intravenous infusion. Our aim was to assess patient reluctance to transition to self-administered augmentation of alpha-1-antitrypsin, during the pandemic of SARS-CoV-2. Methods A phone questionnaire was administered to 22 patients with severe alpha-1-antitrypsin deficiency who were currently receiving AAT augmentation therapy. Inclusion criteria included patients \documentclass[12pt]{minimal}
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\begin{document}$$\ge$$\end{document}≥ 18 years old, diagnosed with AATD, and receiving intravenous AAT protein augmentation therapy. Information was gathered regarding demographics, perspectives on transitioning to self-administered treatment, and anxiety and depression prevalence. Results were collected anonymously using REDCap. Joint and marginal statistical analysis was done to quantify links between participants’ willingness to transition to self-infusion and correlations with sex, age, years of therapy, anxiety, and depression. Results Of 22 patients, 14 were male and eight were female. Ages ranged from 36 to 79 years, with an average of 62.5. Genotypes were ZZ (14), MZ (3), and SZ (2) among others. Average length of intravenous augmentation was 9.5 years. The majority, 16 participants, were aware self-infusion was an option. Eight participants were willing to consider transitioning to self-infusion if trained and educated. Eight patients reported that fear of COVID-19 transmission influenced their decision-making. Above-normal anxiety, and depression scores, were found in four, and six patients, respectively. Neither sex, age, years of treatment, anxiety, or depression were found to be associated with willingness to consider self-infusion therapy. Conclusions Although there are many reasons AATD patients may benefit from AAT self-infusion, including decreased exposure to SARS-CoV-2, the majority preferred home nurse-infused therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s41030-022-00182-z.
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Affiliation(s)
| | | | - Xiang Zhan
- Penn State College of Medicine, Hershey, PA, USA
| | - Sundeep Kaur
- Penn State College of Medicine, Hershey, PA, USA
| | - Timothy Craig
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Pediatrics, Penn State Health, 500 University Drive, Hershey, PA, 17033, USA.
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Hussain Z, Devlin L. Safety Evaluation of an Expedited Omalizumab Home Self-Administration Pathway. Cureus 2021; 13:e19434. [PMID: 34790499 PMCID: PMC8584126 DOI: 10.7759/cureus.19434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction The Northern Ireland Regional Immunology Service (NIRIS) has developed an expedited omalizumab home self-administration pathway to reduce face-to-face clinic attendance during the coronavirus disease 2019 (COVID-19) pandemic. This audit evaluates the safety of this pathway with a particular focus on anaphylaxis. Objectives This study aimed to retrospectively audit the records of 39 patients undertaking expedited home self-administration at NIRIS for complications, particularly emergency department attendance for anaphylaxis. The target was for 100% of patients to complete a six-month course without experiencing anaphylaxis related to omalizumab administration. Materials and methods A total of 39 records of patients who underwent expedited omalizumab self-administration were audited by a single reviewer. They were prospectively collected between March 2020 and August 2021. Clinical data were collected from the Northern Ireland Electronic Care Record (NIECR). Results Hundred percent of patients were in the process of completing or had completed a six-dose course without anaphylaxis. During the course of omalizumab, 7.6% of patients attended the emergency department. Zero percent of patients have experienced anaphylaxis triggered by omalizumab. The target of 100% patients completing the expedited pathway without omalizumab-related anaphylaxis was met. Conclusion Home self-administration of omalizumab is preferred by patients and clinicians for reducing expense, travel, and unnecessary clinical contact during the COVID-19 pandemic. An expedited omalizumab home self-administration training pathway appears to be safe in a population of Northern Irish patients with chronic spontaneous urticaria (CSU). More research is needed to determine whether the expedited pathway should become the standard of care post-pandemic
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Affiliation(s)
- Zobia Hussain
- Emergency Medicine, Royal Victoria Hospital, Belfast, GBR
| | - Lisa Devlin
- Allergy and Immunology, Royal Victoria Hospital, Belfast, GBR
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Menzella F, Ferrari E, Ferrucci SM, Lombardi E, Alfano S, Bonavita O, Morini P, Rizzi A, Matucci A. Self-administration of omalizumab: why not? A literature review and expert opinion. Expert Opin Biol Ther 2021; 21:499-507. [PMID: 33504237 DOI: 10.1080/14712598.2021.1882990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Introduction: Omalizumab is used to treat severe uncontrolled allergic asthma and chronic spontaneous urticaria (CSU), and is approved for self-administration in prefilled syringes. It is thus important to understand the advantages, critical issues, and indications for home administration.Areas covered: The present review summarizes the available evidence on home administration of omalizumab in asthma and CSU to illustrate the advantages derived from self-administration of patients in this setting.Expert opinion: The available data suggest that patients can safely administer biologics at home with suitable training, and that home administration is time saving and cost-effective. The majority of patients with severe asthma or CSU treated with omalizumab are likely to be suitable candidates for self-administration, which can be proposed to anyone that the clinician deems suitable. In addition to clinicians, pharmacists can also play a key role in managing patients who are prescribed home administration. A practical flow chart is proposed on selection of patients and their management during home administration. Self-administration of biologics can be considered as a valid alternative to traditional injections in a clinical setting, and the evidence has shown that no major issues need to be overcome in terms of safety or efficacy.
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Affiliation(s)
- Francesco Menzella
- Pneumology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia- IRCCS, Reggio Emilia, Italy
| | - Emanuele Ferrari
- Hospital Pharmacy, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy
| | - Silvia Mariel Ferrucci
- Servizio di Dermatologia Allergologica e Professionale, U.O.C. Dermatologia. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enrico Lombardi
- Pediatric Pulmonary Unit, "Meyer" Pediatric University Hospital, Florence, Italy
| | | | | | | | | | - Andrea Matucci
- Immunoallergology Unit, University Hospital Careggi, Florence, Italy
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