Biyolojik Ajan Tedavisi Alan Ağır Astımlı Hastalarda COVID-19 Pandemisi Sırasında Tedaviye Uyumdaki Değişiklikler

Öz

Amaç: Bu çalışmada, kliniğimizde omalizumab ve mepolizumab tedavisi alan ağır astımlı hastalarda COVID-19 pandemisinin tedaviye uyum üzerindeki etkilerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 45'i omalizumab ve 8'i mepolizumab kullanan ağır astımlı 53 hasta dahil edildi. Hastaların tıbbi kayıtları isimsiz ve geriye dönük olarak kaydedildi. Bulgular: Çalışma popülasyonunda omalizumab kullanan hasta oranının pandemi öncesi 1 yıllık döneme göre pandemi döneminde azaldığı görüldü. Omalizumab kullanan hastaların yaklaşık %51'inin rutin tedavi dozlarını kaçırdığı gözlendi. Tedavi dozlarının atlanmasındaki en büyük faktör, hastaneye kabul edildikten sonra COVID-19'a yakalanma korkusuydu. Mepolizumab grubunda pandemi döneminde biyolojik ajan kullanma oranı pandemi öncesi 1 yıl öncesine göre artış gösterdi. Bu gruptaki hastaların %37,5'inde doz atlama gözlemlendi ve doz atlamanın en büyük risk faktörünün hastaneye başvuruda COVID-19 kapma korkusu olduğu bulundu. Sonuç: Bu çalışmada, bir sağlık kuruluşunda sağlık profesyoneli gözetiminde uygulanan biyolojik ajan tedavilerinin pandemi döneminde ağır astımı olan hastalarda kullanım süre ve oranlarında azalma olduğu saptanmıştır.

Anahtar Kelimeler

• Koronavirus Anksiyete Ölçeği
• Mepolizumab
• Omalizumab
• SARS-CoV-2

Changes in Treatment Adherence During the COVID-19 Pandemic in Patients with Severe Asthma Receiving Biologic Agent Treatment

Öz

Aim: This study aimed to evaluate the effects of the COVID-19 pandemic on treatment adherence in patients with severe asthma who were receiving omalizumab and mepolizumab treatment in our clinic. Material and Method: A total of 53 patients with severe asthma, 45 of whom were using omalizumab and 8 of whom were using mepolizumab, were included in the study. The medical records of the patients were recorded anonymously and retrospectively. Results: It was seen that the rate of patients using omalizumab in the study population decreased during the pandemic period compared to the 1-year period before the pandemic. It was observed that approximately 51% of the patients using omalizumab missed routine treatment doses. The major factor in skipping treatment doses was the fear of contracting COVID-19 upon admission to the hospital. In the mepolizumab group, the rate of using biologic agents during the pandemic period increased compared to 1 year before the pandemic. Dose skipping was observed among 37.5% of the patients in this group and it was found that the major risk factor for skipping a dose was the fear of contracting COVID-19 upon admission to the hospital. Conclusion: In this study, it was found that there was a decrease in the duration and rate of use of biologic agent therapies administered in a health institution under the supervision of a healthcare professional among patients with severe asthma during the pandemic.

Anahtar Kelimeler

• Coronavirus Anxiety Scale
• Mepolizumab
• Omalizumab
• SARS-CoV-2

Kaynakça

1. Kaplan A, van Boven JF, Ryan D, Tsiligianni I, Bosnic-Anticevich S, Group RAW. GINA 2020: Potential Impacts, Opportunities, and Challenges for Primary Care. J Allergy Clin Immunol Pract 2021;9(4):1516-9.
2. Krings JG, McGregor MC, Bacharier LB, Castro M. Biologics for Severe Asthma: Treatment-Specific Effects Are Important in Choosing a Specific Agent. J Allergy Clin Immunol Pract 2019;7(5):1379-92.
3. Cote A, Godbout K, Boulet LP, The management of severe asthma in 2020. Biochem Pharmacol 2020;179:114112.
4. Schoettler N, Strek ME, Recent Advances in Severe Asthma: From Phenotypes to Personalized Medicine. Chest 2020;157(3):516-28.
5. Papadopoulos NG, Barnes P, Canonica GW, et al., The evolving algorithm of biological selection in severe asthma. Allergy 2020;75(7):1555-63.
6. Zhu N, Zhang D, Wang W, et al., A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382(8):727-33.
7. Kaye L, Theye B, Smeenk I, Gondalia R, Barrett MA, Stempel DA. Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic. J Allergy Clin Immunol Pract 2020;8(7):2384.
8. Akenroye AT, Wood R, Keet C. Asthma, biologics, corticosteroids, and coronavirus disease 2019. Ann Allergy Asthma Immunol 2020;125(1):12.

9. Reddel HK, Bacharier LB, Bateman ED, et al., Global Initiative for Asthma (GINA) Strategy 2021–Executive summary and rationale for key changes. J Allergy Clin Immunol Pract 2021.
10. Beasley R, Braithwaite I, Semprini A, et al., ICS-formoterol reliever therapy stepwise treatment algorithm for adult asthma 2020, Eur Respiratory Soc.
11. Lee SA, Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death studies 2020;44(7):393-401.
12. Bicer İ, Çakmak C, Demir H, Kurt ME. Koronavirüs anksiyete ölçeği kısa formu: Türkçe geçerlik ve güvenirlik çalışması. Anadolu Klinigi 2020;25(Special Issue on COVID 19):216-25.
13. Girija A, Shankar EM, Larsson M. Could SARS-CoV-2-induced hyperinflammation magnify the severity of coronavirus disease (COVID-19) leading to acute respiratory distress syndrome? Front immunol 2020;11:1206.
14. Singhal T. A review of coronavirus disease-2019 (COVID-19). Indian J Pediatr 2020;87(4):281-6.
15. Maveddat A, Mallah H, Rao S, Ali K, Sherali S, and Nugent K, Severe acute respiratory distress syndrome secondary to coronavirus 2 (SARS-CoV-2). Int J Occup Environ Med 2020;11(4):157.
16. Liu S, Cao Y, Du T, Zhi Y. Prevalence of comorbid asthma and related outcomes in COVID-19:a systematic review and meta-analysis. J Allergy Clin Immunol Pract 2021;9(2):693-701.
17. Choi YJ, Park J-Y, Lee HS, et al., Effect of asthma and asthma medication on the prognosis of patients with COVID-19. Eur Respir J 2021;57(3).
18. Kwok WC, Tam AR, Ho JCM, et al., Asthma, from mild to severe, is an independent prognostic factor for mild to severe Coronavirus disease 2019 (COVID‐19). Clin Respir J 2022.
19. Goyal M, Singh P, Singh K, Shekhar S, Agrawal N, Misra S. The effect of the COVID‐19 pandemic on maternal health due to delay in seeking health care:experience from a tertiary center. Int J Gynaecol Obstet 2021;152(2):231-5.