{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:38:32Z","timestamp":1789688312328,"version":"4.0.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids\u00a0(OCS), which worsen patients\u2019 health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab\u00a0(OMA) to mepolizumab\u00a0(MEP) in patients eligible for both biologics, but not optimally controlled by omalizumab. We retrospectively enrolled uncontrolled severe asthmatic patients who switched from OMA to MEP during the last two years. Information included blood eosinophil count, asthma control test (ACT), spirometry, serum IgE, fractional exhaled nitric oxide (FeNO), OCS intake, drugs, exacerbations\/hospitalizations, visits and diagnostic exams. Within the perspective of Italian National Health System, a pre- and post-MEP 12-month standardized total cost per patient was calculated. 33 patients were enrolled: five males, mean age 57\u00a0years, disease onset 24\u00a0years. At OMA discontinuation, 88% were OCS-dependent with annual mean rate of 4.0 clinically significant exacerbations, 0.30 exacerbations needing emergency room visits or hospitalization; absenteeism due to disease was 10.4\u00a0days per patient. Switch to MEP improved all clinical outcomes, reducing total exacerbation rate (RR\u2009=\u20090.06, 95% CI 0.03\u20130.14), OCS-dependent patients (OR\u2009=\u20090.02, 95% CI 0.005\u20130.08), and number of lost working days (\u0394\u2009=\u2009\u2212\u20097.9, 95% CI \u2212\u200911.2 to \u2212\u20094.6). Pulmonary function improved, serum IgE, FeNO and eosinophils decreased. Mean annual costs were \u20ac12,239 for OMA and \u20ac12,639 for MEP (\u0394\u2009=\u2009\u20ac400, 95% CI \u2212\u20091588\u20132389); the increment due to drug therapy (+\u2009\u20ac1,581) was almost offset by savings regarding all other cost items (\u2212\u2009\u20ac1,181). Patients with severe eosinophilic asthma, not controlled by OMA, experienced comprehensive benefits by switching to MEP with only slight increases in economic costs.<\/jats:p>","DOI":"10.1038\/s41598-021-84895-2","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T11:03:14Z","timestamp":1615287794000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical and economic consequences of switching from omalizumab to mepolizumab in uncontrolled severe eosinophilic asthma"],"prefix":"10.1038","volume":"11","author":[{"given":"Giovanna Elisiana","family":"Carpagnano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Resta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Povero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Pelaia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariella","family":"D\u2019Amato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nunzio","family":"Crimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Scichilone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Scioscia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onofrio","family":"Resta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Calabrese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girolamo","family":"Pelaia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Pia Foschino","family":"Barbaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"issue":"3","key":"84895_CR1","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/j.1398-9995.2004.00772.x","volume":"60","author":"M Humbert","year":"2005","unstructured":"Humbert, M. et al. Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE. Allergy 60(3), 309\u2013316 (2005).","journal-title":"Allergy"},{"key":"84895_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2018.12.001","author":"GW Canonica","year":"2019","unstructured":"Canonica, G. W. et al. Shadow cost of oral corticosteroids-related adverse events: A pharmacoeconomic evaluation applied to real-life data from the Severe Asthma Network in Italy (SANI) registry. World Allergy Organ. J. https:\/\/doi.org\/10.1016\/j.waojou.2018.12.001 (2019).","journal-title":"World Allergy Organ. J."},{"key":"84895_CR3","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1007\/s40273-018-0658-x","volume":"36","author":"RB McQueen","year":"2018","unstructured":"McQueen, R. B. et al. Cost-effectiveness of biological asthma treatments: s systematic review and recommendations for future economic evaluations. Pharmacoeconomics 36, 957\u2013971. https:\/\/doi.org\/10.1007\/s40273-018-0658-x (2018).","journal-title":"Pharmacoeconomics"},{"key":"84895_CR4","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/j.1398-9995.2010.02336.x","volume":"65","author":"JD Campbell","year":"2010","unstructured":"Campbell, J. D., Spackman, D. E. & Sullivan, S. D. The costs and consequences of omalizumab in uncontrolled asthma from a USA payer perspective. Allergy 65, 1141\u20131148 (2010).","journal-title":"Allergy"},{"issue":"2","key":"84895_CR5","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/j.anai.2016.10.028","volume":"118","author":"MD Whittington","year":"2017","unstructured":"Whittington, M. D. et al. Assessing the value of mepolizumab for severe eosinophilic asthma: A cost-effectiveness analysis. Ann. Allergy Asthma Immunol. 118(2), 220\u2013225. https:\/\/doi.org\/10.1016\/j.anai.2016.10.028 (2017).","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"84895_CR6","first-page":"175","volume":"12","author":"C Pelaia","year":"2018","unstructured":"Pelaia, C. et al. Omalizumab, the first available antibody for biological treatment of severe asthma: MORE than a decade of real-life effectiveness. Adv. Respir. Dis. 12, 175 (2018).","journal-title":"Adv. Respir. Dis."},{"key":"84895_CR7","first-page":"549252","volume":"2013","author":"F Braido","year":"2013","unstructured":"Braido, F. Failure in asthma control: Reasons and consequences. Scientifica (Cairo). 2013, 549252 (2013).","journal-title":"Scientifica (Cairo)."},{"issue":"13","key":"84895_CR8","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1056\/NEJMoa1403290","volume":"371","author":"HG Ortega","year":"2014","unstructured":"Ortega, H. G. et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N. Engl. J. Med. 371(13), 1198\u20131207 (2014).","journal-title":"N. Engl. J. Med."},{"issue":"9842","key":"84895_CR9","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/S0140-6736(12)60988-X","volume":"380","author":"ID Pavord","year":"2012","unstructured":"Pavord, I. D. et al. Mepolizumab for severe eosinophilic asthma (DREAM): A multicentre, double-blind, placebo-controlled trial. Lancet 380(9842), 651\u2013659 (2012).","journal-title":"Lancet"},{"issue":"10","key":"84895_CR10","doi-asserted-by":"publisher","first-page":"237","DOI":"10.2147\/JAA.S144100","volume":"30","author":"F Menzella","year":"2017","unstructured":"Menzella, F. et al. Innovative treatments for severe refractory asthma: How to choose the right option for the right patient?. J. Asthma Allergy. 30(10), 237\u2013247. https:\/\/doi.org\/10.2147\/JAA.S144100 (2017).","journal-title":"J. Asthma Allergy."},{"issue":"12","key":"84895_CR11","doi-asserted-by":"publisher","first-page":"2539","DOI":"10.1111\/all.13937","volume":"74","author":"DE Bagnasco","year":"2019","unstructured":"Bagnasco, D. E. et al. Efficacy of mepolizumab in patients with previous omalizumab treatment failure: Real-life observation. Allergy 74(12), 2539\u20132541. https:\/\/doi.org\/10.1111\/all.13937 (2019).","journal-title":"Allergy"},{"key":"84895_CR12","doi-asserted-by":"publisher","first-page":"1716","DOI":"10.1111\/all.13850","volume":"74","author":"KR Chapman","year":"2019","unstructured":"Chapman, K. R. et al. The clinical benefit of mepolizumab replacing omalizumab in uncontrolled severe eosinophilic asthma. Allergy 74, 1716\u20131726. https:\/\/doi.org\/10.1111\/all.13850 (2019).","journal-title":"Allergy"},{"key":"84895_CR13","unstructured":"GINA. Global strategy for asthma management and prevention (2019 update) https:\/\/ginasthma.org\/wp-content\/uploads\/2019\/06\/GINA-2019-main-report-June-2019-wms.pdf Accessed April 2020."},{"key":"84895_CR14","unstructured":"Summary of Product Characteristics (SPC) omalizumab [Internet]. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/xolair-epar-product-information_en.pdf Accessed April 2020."},{"key":"84895_CR15","unstructured":"Informatore farmaceutico 2020 [Internet]. Available from: www.codifa.it Accessed April 2020."},{"key":"84895_CR16","unstructured":"Anagrafica SORESA [Internet]. Available from: https:\/\/www.soresa.it\/imprese\/Pagine\/Anagrafica-Beni.aspx Accessed April 2020."},{"key":"84895_CR17","unstructured":"Lista farmaci equivalenti [Internet]. Available from: http:\/\/www.agenziafarmaco.gov.it\/content\/liste-di-trasparenza-e-rimborsabilit\u00e0 Accessed April 2020."},{"key":"84895_CR18","unstructured":"Bollettino Ufficiale della Regione (BUR) Campania - Deliberazione giunta regionale n 270 del 12.06.2012 [Internet]. Available from: http:\/\/burc.regione.campania.it\/eBurcWeb\/BurcPdfOutput\/Burc_2012_6_26_11_15.pdf;jsessionid=FBD71BD1D08E8E2D8A98142BA07C4740.burcfe2 Accessed April 2020."},{"key":"84895_CR19","unstructured":"GU Serie Generale n.23 del 28\u201301\u20132013 - Suppl. Ordinario n. 8. Decreto\u00a018 ottobre 2012. Remunerazione prestazioni di assistenza ospedaliera per acuti, assistenza ospedaliera di riabilitazione e di lungodegenza post acuzie e di assistenza specialistica ambulatoriale. (13A00528) [Internet]. Available from https:\/\/www.gazzettaufficiale.it\/eli\/id\/2013\/01\/28\/13A00528\/sg Accessed April 2020."},{"key":"84895_CR20","doi-asserted-by":"crossref","unstructured":"Pradelli L, Ghetti G. A general model for the estimation of societal costs of lost production and informal care in Italy. Farmeconomia Heal Econ Ther pathways. 2017 Feb 21;18(1).","DOI":"10.7175\/fe.v18i1.1278"},{"key":"84895_CR21","unstructured":"Harmonized Indices of Consumer Prices (HICP), European Commission EuroStat 2020 [Internet]. Available from: https:\/\/ec.europa.eu\/eurostat\/web\/hicp\/data\/main-tables Accessed April 2020."},{"issue":"4","key":"84895_CR22","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1002\/pst.141","volume":"3","author":"ON Keene","year":"2004","unstructured":"Keene, O. N., Davis, R. L. & Koch, G. G. Use of generalized estimating equations in a trial in influenza to explore treatment effects over time. Pharm Stat. 3(4), 281\u2013287 (2004).","journal-title":"Pharm Stat."},{"key":"84895_CR23","unstructured":"Summary of Product Characteristics (SPC) mepolizumab [Internet]. Available from: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/nucala-epar-product-information_en.pdf Accessed April 2020."},{"issue":"5","key":"84895_CR24","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1016\/j.jaci.2012.01.039","volume":"129","author":"JI Ivanova","year":"2012","unstructured":"Ivanova, J. I. et al. Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma. J. Allergy Clin. Immunol. 129(5), 1229\u20131235. https:\/\/doi.org\/10.1016\/j.jaci.2012.01.039 (2012).","journal-title":"J. Allergy Clin. Immunol."},{"issue":"2","key":"84895_CR25","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.rmed.2009.09.011","volume":"104","author":"M Massanari","year":"2010","unstructured":"Massanari, M. et al. Effect of omalizumab on peripheral blood eosinophilia in allergic asthma. Respir. Med. 104(2), 188\u2013196. https:\/\/doi.org\/10.1016\/j.rmed.2009.09.011 (2010).","journal-title":"Respir. Med."},{"issue":"supplement 3","key":"84895_CR26","doi-asserted-by":"publisher","first-page":"s413","DOI":"10.1016\/j.jval.2018.09.2449","volume":"21","author":"F Maunoury","year":"2018","unstructured":"Maunoury, F. et al. Cost-effectiveness of mepolizumab in severe eosinophilic asthma patients in France. Value Health 21(supplement 3), s413. https:\/\/doi.org\/10.1016\/j.jval.2018.09.2449 (2018).","journal-title":"Value Health"},{"issue":"2","key":"84895_CR27","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1080\/14737167.2017.1298444","volume":"17","author":"A Basu","year":"2017","unstructured":"Basu, A. et al. Economic analysis of the phase III MENSA study evaluating mepolizumab for severe asthma with eosinophilic phenotype. Exp. Rev. Pharmacoecon. Outcomes Res. 17(2), 121\u2013131. https:\/\/doi.org\/10.1080\/14737167.2017.1298444 (2017).","journal-title":"Exp. Rev. Pharmacoecon. Outcomes Res."},{"issue":"1","key":"84895_CR28","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/ACI.0000000000000493","volume":"19","author":"E Heffler","year":"2019","unstructured":"Heffler, E., Bagnasco, D. & Canonica, G. W. Strategies to reduce corticosteroid-related adverse events in asthma. Curr. Opin. Allergy Clin. Immunol. 19(1), 61\u201367 (2019).","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"issue":"5","key":"84895_CR29","doi-asserted-by":"publisher","first-page":"1462","DOI":"10.1016\/j.jaip.2018.10.016","volume":"7","author":"E Heffler","year":"2019","unstructured":"Heffler, E. et al. The severe asthma network in Italy: Findings and perspectives. J. Allergy Clin. Immunol. Pract. 7(5), 1462\u20131468 (2019).","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"84895_CR30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12948-017-0065-4","volume":"15","author":"G Senna","year":"2017","unstructured":"Senna, G. et al. SANI-Severe asthma network in Italy: A way forward to monitor severe asthma. Clin. Mol. Allergy. 15, 1 (2017).","journal-title":"Clin. Mol. Allergy."},{"key":"84895_CR31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40413-018-0210-7","volume":"11","author":"D Bagnasco","year":"2018","unstructured":"Bagnasco, D. et al. The North-Western Italian experience with anti IL-5 therapy amd comparison with regulatory trials. World Allergy Organ J. 11, 1 (2018).","journal-title":"World Allergy Organ J."},{"issue":"6","key":"84895_CR32","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1067\/mai.2003.1449","volume":"111","author":"MG Cisternas","year":"2003","unstructured":"Cisternas, M. G. et al. A comprehensive study of the direct and indirect costs of adult asthma. J. Allergy Clin. Immunol. 111(6), 1212\u20131218 (2003).","journal-title":"J. Allergy Clin. Immunol."},{"key":"84895_CR33","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3389\/fpubh.2017.00067","volume":"5","author":"K Souliotis","year":"2017","unstructured":"Souliotis, K. et al. Direct and indirect costs of asthma management in Greece: An expert Panel approach. Front. Public Health 5, 67. https:\/\/doi.org\/10.3389\/fpubh.2017.00067 (2017).","journal-title":"Front. Public Health"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84895-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84895-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84895-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,25]],"date-time":"2024-08-25T18:06:28Z","timestamp":1724609188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-84895-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,9]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["84895"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-84895-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,9]]},"assertion":[{"value":"29 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.P. is employee of AdRes, which has received unconditional project funding from GSK. None for other authors.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"5453"}}