Antitussive Use in Patients with Inadequately Controlled Moderate-to-Severe Asthma: A Post Hoc Analysis of the Omalizumab EXTRA Trial

Abstract

Acute and chronic cough are common symptoms in patients with severe allergic asthma. Although asthma-related cough can be controlled by asthma-specific medications, both prescription and over-the-counter antitussives are often also necessary. The anti-immunoglobulin E monoclonal antibody omalizumab is an effective treatment for patients with moderate-to-severe asthma, but little is known about subsequent antitussive use patterns. This post hoc analysis examined data from the Phase 3 EXTRA study that included patients aged 12–75 years with inadequately controlled moderate-to-severe asthma. Baseline antitussive use was low overall (16/427, 3.7% for omalizumab and 18/421, 4.3% for placebo). Among patients with no baseline antitussive use (n = 411 omalizumab, n = 403 placebo), most patients (88.3% omalizumab, 83.4% placebo) reported not using antitussives during the 48-week treatment period. The percentage of patients using 1 antitussive was lower for patients treated with omalizumab than placebo (7.1% vs 13.2%), although the adjusted rate of antitussive use during the treatment period was similar for omalizumab and placebo (0.22 and 0.25). Non-narcotics were used more often than narcotics. In conclusion, this analysis found low use of antitussives in patients with severe asthma and suggests that omalizumab may have the potential to decrease antitussive use.

Keywords:

• antitussive
• asthma
• cough
• omalizumab

Abbreviation

ICS, inhaled corticosteroids.

Data Sharing Statement

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Acknowledgments

Medical writing assistance was provided by Janelle Keys, PhD, CMPP of Envision Pharma Group, and funded by Genentech, Inc., a member of the Roche Group. Envision Pharma Group’s services complied with international guidelines for Good Publication Practice (GPP 2022).

This paper was presented at the American Thoracic Society Annual Meeting, May 13-18, 2022, in San Francisco, CA, USA, as a poster presentation with interim findings.

Disclosure

CJR is an owner of Medicine Deconstructed Productions and reports personal fees from Sanofi, Regeneron, Boehringer Ingelheim, United Therapeutics, Amgen, AstraZeneca, Olympus, Moderna, and Pfizer, outside the submitted work. OII is a consultant for Blueprint Medicines and Novartis and reports grants from NIH NIAID K08AI141691, grants from 2020 American Association of Allergy, Asthma, and Immunology Foundation Faculty Development Award, outside the submitted work. KA, JK, PM and SG are employees of Genentech, Inc. SG is a shareholder of Genentech, Inc. AM has no conflicts of interest to declare.

Additional information

Funding

The EXTRA clinical trial was funded by Genentech, Inc., a member of the Roche Group, and Novartis Pharma AG, and this analysis was funded by Genentech, Inc., a member of the Roche Group.