PMID- 30533206
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240405
IS  - 2001-8525 (Print)
IS  - 2001-8525 (Electronic)
IS  - 2001-8525 (Linking)
VI  - 5
IP  - 1
DP  - 2018
TI  - Efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab 
      anti-IL-5 treatments of severe asthma - a systematic review and meta-analysis.
PG  - 1536097
LID - 10.1080/20018525.2018.1536097 [doi]
LID - 1536097
AB  - Background: New, complex, and expensive therapies targeting Interleukin-5 (IL-5) 
      to treat severe eosinophilic asthma are emerging. Objective: To assess efficacy, 
      adverse events, and inter-drug comparison of mepolizumab and reslizumab for 
      treating severe eosinophilic asthma. Design: A systematic review and 
      meta-analysis on randomized, placebo-controlled, clinical trials elucidating two 
      critical (exacerbation rate and oral corticosteroid (OCS) use) and six important 
      clinical outcomes on the efficacy and safety of mepolizumab and reslizumab. 
      Results: Five studies (N = 2197) contributed with data for exacerbation rate, 
      showing a reduction of 53% (95% CI 46; 59) in favour of anti-IL-5, corresponding 
      to -0.94 annual exacerbations (95% CI -1.08;-0.82), thus exceeding the predefined 
      minimal clinical important difference (MCID) of 25% reduction of the estimated >/=2 
      annual exacerbations. Quality of evidence was considered moderate, with low 
      heterogeneity in study findings (I2 = 0%). One study (N = 135) contributed with 
      data on percentage of patients experiencing >/=50% reduction inoral corticosteroid 
      treatment, showing an effect of 20% (95% CI 2.3;47) in favour of anti-IL-5 
      treatment (mepolizumab), thus exceeding the predefined MCID of 10%. Quality of 
      evidence was considered low. Compared to placebo, anti-IL-5 showed significant 
      improvements in lung function, asthma control, and asthma-related quality of 
      life, but below the MCIDs. No differences were observed for serious adverse 
      events and number of patients, who dropped out. No studies evaluating sickleave 
      or head-to-head comparisons were identified. By indirect comparison, we found no 
      significant difference between mepolizumab and reslizumab in any ofthe predefined 
      clinical outcomes. OCS treatment reduction could not be compared due to lack of 
      reslizumab studies investigating this outcome. Conclusions: Mepolizumab and 
      reslizumab provide significant and clinically relevant improvements in 
      exacerbation rate and OCS reduction. Indirect, inter-study comparisons revealed 
      no differences between the anti-IL-5 drugs in efficacy or safety measures.
FAU - Henriksen, Daniel P
AU  - Henriksen DP
AUID- ORCID: 0000-0003-1303-6195
AD  - Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, 
      Odense, Denmark.
FAU - Bodtger, Uffe
AU  - Bodtger U
AUID- ORCID: 0000-0002-1231-9209
AD  - Department of Respiratory Medicine, Naestved Hospital, Naestved, Denmark.
FAU - Sidenius, Kirsten
AU  - Sidenius K
AD  - Allergi og Lungeklinikken Helsingor, Helsingor, Denmark.
FAU - Maltbaek, Niels
AU  - Maltbaek N
AD  - Department of Medicine, Zealand University Hospital, Roskilde, Denmark.
FAU - Pedersen, Lars
AU  - Pedersen L
AD  - Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
FAU - Madsen, Hanne
AU  - Madsen H
AD  - Department of Respiratory Medicine, Odense University Hospital, Odense, Denmark.
FAU - Andersson, Ehm A
AU  - Andersson EA
AD  - The Danish Medicines Council Secretariat, Copenhagen, Denmark.
FAU - Norgaard, Ole
AU  - Norgaard O
AUID- ORCID: 0000-0002-1681-4338
AD  - The Danish Medicines Council Secretariat, Copenhagen, Denmark.
FAU - Madsen, Louise Klokker
AU  - Madsen LK
AUID- ORCID: 0000-0003-2463-0990
AD  - The Danish Medicines Council Secretariat, Copenhagen, Denmark.
FAU - Chawes, Bo L
AU  - Chawes BL
AUID- ORCID: 0000-0001-6846-6243
AD  - COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and 
      Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20181107
PL  - United States
TA  - Eur Clin Respir J
JT  - European clinical respiratory journal
JID - 101662134
PMC - PMC6282428
OTO - NOTNLM
OT  - Severe asthma
OT  - anti-IL-5
OT  - mepolizumab
OT  - reslizumab
OT  - systematic review
EDAT- 2018/12/12 06:00
MHDA- 2018/12/12 06:01
PMCR- 2018/11/07
CRDT- 2018/12/12 06:00
PHST- 2018/05/16 00:00 [received]
PHST- 2018/08/28 00:00 [revised]
PHST- 2018/10/06 00:00 [accepted]
PHST- 2018/12/12 06:00 [entrez]
PHST- 2018/12/12 06:00 [pubmed]
PHST- 2018/12/12 06:01 [medline]
PHST- 2018/11/07 00:00 [pmc-release]
AID - 1536097 [pii]
AID - 10.1080/20018525.2018.1536097 [doi]
PST - epublish
SO  - Eur Clin Respir J. 2018 Nov 7;5(1):1536097. doi: 10.1080/20018525.2018.1536097. 
      eCollection 2018.