HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Berger, A. Articles by Oster, G. Search for Related Content PubMed Articles by Berger, A. Articles by Oster, G.

Clinical Outcomes in Patients With Alpha1-Antitrypsin Deficiency And Emphysema Receiving Alpha1-Proteinase Inhibitor Augmentation Therapy

Baxter BioScience, Westlake Village, CA

PURPOSE: Alpha1-antitrypsin (AAT) deficiency is a common genetic disorder with prevalence similar to that of cystic fibrosis. Chronic augmentation therapy with alpha1-proteinase inhibitor (A1-PI) slows the progression of emphysema. We compared selected clinical outcomes in patients with AAT deficiency and emphysema who had received A1-PI augmentation versus those who had not.

METHODS: Using a large health-care claims database (12M covered lives), we identified all patients with one or more claims with an ICD-9-CM diagnosis code for AAT deficiency and one or more claims with a diagnosis code for emphysema during calendar year (CY) 2002. We then stratified patients according to whether or not they received A1-PI therapy during CY2002, and compared selected clinical measures between these groups.

RESULTS: A total of 771 patients were identified in CY2002 with AAT deficiency, of whom 197 also had emphysema. Only 116 (59% of all patients with AAT deficiency and emphysema) received A1-PI augmentation therapy. Patients who had received A1-PI augmentation did not differ with respect to age, sex, or the prevalence of other respiratory diseases from those who had not. A1-PI augmented patients were more likely to have received bronchodilators (91% vs 64%; p<0.01), supplemental oxygen (19% vs 4%; p<0.01), and inhaled corticosteroids (69% vs 44%; p<0.01); they were less likely to have received outpatient intravenous antibiotics (2% vs 14% respectively; p<0.01), and had fewer hospitalizations per patient (0.3 vs 0.8; p<0.01).

CONCLUSION: Substantial number of patients with emphysema secondary to AAT deficiency may not be receiving A1-PI augmentation therapy. Augmentation therapy with A1-PI may positively impact clinical outcomes, as evidenced by lower rates of hospitalizations and outpatient intravenous antibiotic use.

CLINICAL IMPLICATIONS: Adherence to ATS/ERS standards (i.e., diagnosis and augmentation with A1-PI) may improve health outcomes and reduce utilization of costly health-care services.

DISCLOSURE: K.C. Chung, Study funded by Baxter BioScience