Costs of Oral Corticosteroid Use in Patients with Severe Asthma With/Without Chronic Rhinosinusitis with Nasal Polyps: Data from the Italian SANI Registry.

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-01-04 DOI:10.1007/s12325-024-03071-w

Enrico Heffler, Francesco Blasi, Pierluigi Paggiaro, Giorgio Walter Canonica

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引用次数: 0

Abstract

Introduction: The burden of severe asthma on patients, especially on those with concomitant chronic rhinosinusitis with nasal polyps (CRSwNP), is substantial. Treatment intensification with oral corticosteroids is a common strategy for managing severe asthma exacerbations; however, prolonged exposure to systemic corticosteroids is associated with multisystem toxicity. This study aimed to quantify the association between oral corticosteroid use and annual asthma-related costs in patients with severe asthma with or without CRSwNP.

Methods: This pharmacoeconomic analysis was based on data from the Severe Asthma Network in Italy (SANI) registry. Asthma-related costs were estimated in the context of the Italian healthcare system and included exacerbations requiring treatment intensification, unplanned visits, admissions to hospital and emergency/intensive care units, and lost workdays. For each item, the mean annual cost per patient was estimated based on national tariffs and the frequency of the event. To quantify the association between oral corticosteroid treatment and costs, the study cohort was stratified according to oral corticosteroid use in the 1-year preceding inclusion in the SANI registry.

Results: A total of 669 patients from the SANI registry were included in the present analysis, 255 of whom had concomitant CRSwNP. Corticosteroid use was associated with significantly higher annual disease-related costs per patient compared with no corticosteroid use. Compared with the overall study cohort and patients without CRSwNP, patients with CRSwNP had higher disease-related costs (higher by €1307 and €1869, respectively).

Conclusion: Use of corticosteroids, in particular systemic corticosteroids, is associated with an increase in asthma-related costs. The concomitant presence of CRSwNP impacts negatively on costs. This study suggests that a thorough analysis of costs, expected benefits, and occurrence of adverse events is required when selecting treatment intensification strategies for managing uncontrolled severe asthma.

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重度哮喘合并/不合并慢性鼻窦炎合并鼻息肉患者口服皮质类固醇的成本：来自意大利SANI注册中心的数据

重度哮喘患者，特别是伴有慢性鼻窦炎伴鼻息肉（CRSwNP）患者的负担是巨大的。强化口服皮质类固醇治疗是控制严重哮喘加重的常用策略；然而，长期暴露于全身皮质类固醇与多系统毒性有关。本研究旨在量化伴有或不伴有CRSwNP的严重哮喘患者口服皮质类固醇使用与年度哮喘相关费用之间的关系。方法：该药物经济学分析基于意大利严重哮喘网络（SANI）登记处的数据。在意大利医疗保健系统的背景下估计哮喘相关费用，包括需要加强治疗的恶化，计划外的就诊，住院和急诊/重症监护病房，以及损失的工作日。对于每个项目，每位患者的平均年成本是根据国家关税和事件频率估计的。为了量化口服皮质类固醇治疗与成本之间的关系，研究队列根据纳入SANI登记前1年的口服皮质类固醇使用情况进行分层。结果：本分析共纳入了来自SANI登记处的669例患者，其中255例伴有CRSwNP。与未使用皮质类固醇的患者相比，使用皮质类固醇的患者每年的疾病相关费用显著增加。与整个研究队列和没有CRSwNP的患者相比，CRSwNP患者的疾病相关费用更高（分别高出1307欧元和1869欧元）。结论：使用皮质类固醇，特别是全身皮质类固醇，与哮喘相关费用的增加有关。CRSwNP的同时存在对成本产生负面影响。这项研究表明，在选择治疗强化策略以管理不受控制的严重哮喘时，需要对成本、预期收益和不良事件的发生进行彻底的分析。

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来源期刊

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.