LOS ANGELES — Patients with chronic spontaneous urticarial who were evaluated by an allergist experienced a marked reduction in corticosteroid prescriptions, according to a recent study presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
“The overall impact of specialty consultation for patients with chronic spontaneous urticaria has never been reported,” researcher Roy A. Orden, MD, of Johns Hopkins University School of Medicine, and colleagues wrote. “The objective of this study was to assess the impact of allergist/immunologist evaluation of chronic spontaneous urticaria patients on filled prescriptions of corticosteroids.”
An interrupted time series analysis using prescription data for patients from the nationwide claims database, Truven Health Analytics MarketScan, was performed by researchers. An ICD-9-CM coding algorithm classified patients with chronic spontaneous urticaria. Only consistently enrolled patients with incident cases of chronic spontaneous urticaria and incident evaluations by an allergy specialist were included in the cohort, composing a total of 635 patients.
According to study results, oral steroid prescriptions rose by 1,579 mg per month in the twelve months prior to the allergy evaluation. Thirty days preceding the date of the allergy visit, steroid prescriptions peaked at 31,145 mg. Due to an artifactual alignment of refills, prescriptions filled on the day of the consultation were eliminated from the study.
Prescriptions declined by 1,580 mg per month in the twelve months following the evaluation. This represented a substantial treatment effect (P=0.0003). Significant drops in filled corticosteroid prescriptions was linked to the introduction of second-line immunomodulators, predominantly cyclosporine, hydroxychloroquine and dapsone.
“The evaluation of patients with chronic spontaneous urticaria by an allergy/immunology specialist is associated with a marked decrease in corticosteroid prescriptions, possibly due to the introduction of immunomodulating agents,” Orden and colleagues concluded. – by Alaina Tedesco
Orden RA, et al. Abstract 789. Presented at: the American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.
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