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

Christine J. Rubeiz, MD; Ricardo Asero, MD; Stephen Betschel, HBSc, MD, FRCP (C); Timothy Craig, DO; Anete Grumach, MD, PhD; Michihiro Hide, MD, PhD; David Lang, MD; Michael Levin, MD, PhD; Hilary Longhurst, MA, PhD, FRACP, FRCPath; Eli Magan, MD; Marcus Maurer, MD; Romi Saini, MD; Gordon Sussman, MD; Elias Toubi, MD; Dinh Nguyen Van, MD, PhD; Torsten Zuberier, MD; Jonathan A. Bernstein, MD

World Allergy Organization Journal (Jan 2024)

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

Christine J. Rubeiz, MD,
Ricardo Asero, MD,
Stephen Betschel, HBSc, MD, FRCP (C),
Timothy Craig, DO,
Anete Grumach, MD, PhD,
Michihiro Hide, MD, PhD,
David Lang, MD,
Michael Levin, MD, PhD,
Hilary Longhurst, MA, PhD, FRACP, FRCPath,
Eli Magan, MD,
Marcus Maurer, MD,
Romi Saini, MD,
Gordon Sussman, MD,
Elias Toubi, MD,
Dinh Nguyen Van, MD, PhD,
Torsten Zuberier, MD,
Jonathan A. Bernstein, MD

Affiliations

Christine J. Rubeiz, MD: Cincinnati Children's Hospital Medical Center, Division of Allergy and Immunology, Cincinnati, OH, USA
Ricardo Asero, MD: Ambulatorio di Allergologia, Clinica San Carlo, Pademo Dugnano, Italy
Stephen Betschel, HBSc, MD, FRCP (C): Unity Health, St Michael's Hospital, University of Toronto, Ontario, Canada
Timothy Craig, DO: Pediatrics and Biomedical Sciences, Penn State University, Hershey, PA, USA
Anete Grumach, MD, PhD: Centro Universitário Faculdade de Medicina ABC, Brazil
Michihiro Hide, MD, PhD: Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
David Lang, MD: Cleveland Clinic Lerner College of Medicine, Department of Allergy and Clinical Immunology, Cleveland, OH, USA
Michael Levin, MD, PhD: University of Cape Town, South Africa
Hilary Longhurst, MA, PhD, FRACP, FRCPath: Department of Medicine, University of Auckland, Te Toka Tumai, New Zealand; Department of Immunology, Auckland City Hospital, Te Toka Tumai, New Zealand
Eli Magan, MD: Assuta Ashdod University Medical Center, Ben Gurion University of the Negev, Israel
Marcus Maurer, MD: Charité and Fraunhofer, Berlin, Germany
Romi Saini, MD: Johns Hopkins University School of Medicine, USA
Gordon Sussman, MD: University of Ontario, Canada
Elias Toubi, MD: University of Haifa, Israel
Dinh Nguyen Van, MD, PhD: Vinmec Healthcare System, Hanoi, Vietnam; College of Health Sciences, Hanoi, Vietnam; Department of Medicine, College of Medicine, Penn State University, USA
Torsten Zuberier, MD: 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, MD: 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; Corresponding author. University of Cincinnati College of Medicine 231 Albert Sabin Way, ML#563 Cincinnati, Ohio 45267, USA.

Journal volume & issue: Vol. 17, no. 1
p. 100858

Abstract

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Background: 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: This study was performed to determine the global prescription of omalizumab for treatment of CSU by allergists/immunologists. Methods: 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: 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: 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.

Published in World Allergy Organization Journal

ISSN: 1939-4551 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.journals.elsevier.com/world-allergy-organization-journal/

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