PMID- 32154939
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210514
IS  - 1398-9995 (Electronic)
IS  - 0105-4538 (Linking)
VI  - 75
IP  - 5
DP  - 2020 May
TI  - Efficacy and safety of treatment with dupilumab for severe asthma: A systematic 
      review of the EAACI guidelines-Recommendations on the use of biologicals in 
      severe asthma.
PG  - 1058-1068
LID - 10.1111/all.14268 [doi]
AB  - Dupilumab, a fully human monoclonal antibody against interleukin-4 receptor alpha, is 
      approved as add-on maintenance treatment for inadequately controlled type 2 
      severe asthma. This systematic review evaluated the efficacy, safety and economic 
      impact of dupilumab compared to standard of care for uncontrolled severe asthma. 
      PubMed, EMBASE and Cochrane Library were searched for RCTs and health economic 
      evaluations. Critical and important asthma-related outcomes were evaluated. The 
      risk of bias and the certainty of the evidence were assessed using GRADE. Three 
      RCTs including 2735 subjects >12 years old and 24-52 weeks of follow-up were 
      included. Dupilumab reduced with high certainty severe asthma exacerbations 
      (Incidence rate ratio 0.51; 95% CI 0.45-0.59) and the percentage use of oral 
      corticosteroid use (mean difference (MD) -28.2 mg/d; 95% CI -40.7 to -15.7). 
      Asthma control (ACQ-5), quality of life (AQLQ) and rescue medication use 
      [puffs/d] improved, without reaching the minimal important clinical difference: 
      ACQ-5 MD -0.28 (95% CI -0.39 to -0.17); AQLQ MD +0.28 (95% CI 0.20-0.37); and 
      rescue medication MD -0.35 (95% CI -0.73 to +0.02). FEV(1) increased (MD +0.15; 
      95% CI +0.11 to +0.18) (moderate certainty). There was an increased rate of 
      dupilumab-related adverse events (AEs) (moderate certainty) and of drug-related 
      serious AEs (low certainty). The incremental cost-effectiveness ratio of 
      dupilumab versus standard therapy was 464 000$/QALY (moderate certainty). More 
      data on long-term safety are needed both for children and for adults, together 
      with more efficacy data in the paediatric population.
CI  - (c) 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
FAU - Agache, Ioana
AU  - Agache I
AUID- ORCID: 0000-0001-7994-364X
AD  - Faculty of Medicine, Transylvania University, Brasov, Romania.
FAU - Song, Yang
AU  - Song Y
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
FAU - Rocha, Claudio
AU  - Rocha C
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
FAU - Beltran, Jessica
AU  - Beltran J
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
FAU - Posso, Margarita
AU  - Posso M
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
AD  - Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical 
      Research Institute), Barcelona, Spain.
FAU - Steiner, Corinna
AU  - Steiner C
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
FAU - Alonso-Coello, Pablo
AU  - Alonso-Coello P
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
AD  - CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain.
FAU - Akdis, Cezmi
AU  - Akdis C
AUID- ORCID: 0000-0001-8020-019X
AD  - Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 
      Davos, Switzerland.
AD  - Christine Kuhne-Center for Allergy Research and Education, Davos, Switzerland.
FAU - Akdis, Mubeccel
AU  - Akdis M
AUID- ORCID: 0000-0003-0554-9943
AD  - Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 
      Davos, Switzerland.
AD  - Christine Kuhne-Center for Allergy Research and Education, Davos, Switzerland.
FAU - Canonica, Giorgio Walter
AU  - Canonica GW
AD  - Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research 
      Center, IRCCS, Rozzano, Italy.
FAU - Casale, Thomas
AU  - Casale T
AUID- ORCID: 0000-0002-3149-7377
AD  - Division of Allergy and Immunology, University of South Florida Morsani College 
      of Medicine, Tampa, FL, USA.
FAU - Chivato, Tomas
AU  - Chivato T
AD  - School of Medicine, University CEU San Pablo, Madrid, Spain.
FAU - Corren, Jonathan
AU  - Corren J
AD  - David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
FAU - Del Giacco, Stefano
AU  - Del Giacco S
AUID- ORCID: 0000-0002-4517-1749
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Monserrato, Italy.
FAU - Eiwegger, Thomas
AU  - Eiwegger T
AUID- ORCID: 0000-0002-2914-7829
AD  - Translational Medicine Program, Research Institute, Hospital for Sick Children, 
      Toronto, ON, Canada.
AD  - Department of Immunology, University of Toronto, Toronto, ON, Canada.
AD  - Division of Immunology and Allergy, Food Allergy and Anaphylaxis Program, 
      Departments of Paediatrics and Immunology, The Hospital for Sick Children, 
      University of Toronto, Toronto, ON, Canada.
FAU - Firinu, Davide
AU  - Firinu D
AUID- ORCID: 0000-0002-5768-391X
AD  - Department of Medical Sciences and Public Health, University of Cagliari, 
      Monserrato, Italy.
FAU - Gern, James E
AU  - Gern JE
AUID- ORCID: 0000-0002-6667-4708
AD  - Department of Pediatrics, School of Medicine and Public Health, University of 
      Wisconsin, Madison, WI, USA.
FAU - Hamelmann, Eckard
AU  - Hamelmann E
AUID- ORCID: 0000-0002-2996-8248
AD  - Klinik fur Kinder- und Jugendmedizin Kinderzentrum Bethel, Bielefeld, Germany.
FAU - Hanania, Nicola
AU  - Hanania N
AD  - Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of 
      Medicine, Houston, TX, USA.
FAU - Makela, Mika
AU  - Makela M
AD  - Skin and Allergy Hospital, Helsinki University Hospital and University of 
      Helsinki, Helsinki, Finland.
FAU - Martin, Irene Hernandez
AU  - Martin IH
AD  - Department of Allergy, Hospital Universitario La Paz, Madrid, Spain.
FAU - Nair, Parameswaran
AU  - Nair P
AUID- ORCID: 0000-0002-1041-9492
AD  - Division of Respirology, Department of Medicine, McMaster University, Hamilton, 
      ON, Canada.
AD  - Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, ON, 
      Canada.
FAU - O'Mahony, Liam
AU  - O'Mahony L
AUID- ORCID: 0000-0003-4705-3583
AD  - Departments of Medicine and Microbiology, APC Microbiome Ireland, University 
      College Cork, Cork, Ireland.
FAU - Papadopoulos, Nikolaos G
AU  - Papadopoulos NG
AUID- ORCID: 0000-0002-4448-3468
AD  - Division of Infection, Immunity & Respiratory Medicine, University of Manchester, 
      Manchester, UK.
AD  - Allergy Department, 2nd Pediatric Clinic, National Kapodistrian University of 
      Athens, Athens, Greece.
FAU - Papi, Alberto
AU  - Papi A
AD  - Department of Medical Sciences, Research Center on Asthma and COPD, University of 
      Ferrara, Ferrara, Italy.
FAU - Park, Hae-Sim
AU  - Park HS
AUID- ORCID: 0000-0003-2614-0303
AD  - Department of Allergy and Clinical Immunology, Ajou University, Suwon, South 
      Korea.
FAU - Perez de Llano, Luis
AU  - Perez de Llano L
AUID- ORCID: 0000-0003-2652-6847
AD  - Department of Respiratory Medicine, Hospital Lucus Augusti, Lugo, Spain.
FAU - Quirce, Santiago
AU  - Quirce S
AD  - Department of Allergy, La Paz University Hospital, IdiPAZ, CIBER of Respiratory 
      Diseases (CIBERES), Universidad Autonoma de Madrid, Madrid, Spain.
FAU - Sastre, Joaquin
AU  - Sastre J
AUID- ORCID: 0000-0003-4689-6837
AD  - Facultad de Medicina, Universidad Autonoma de Madrid, Madrid, Spain.
FAU - Shamji, Mohamed
AU  - Shamji M
AUID- ORCID: 0000-0003-3425-3463
AD  - Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, 
      Inflammation, National Heart and Lung Institute, London, UK.
AD  - Imperial College NIHR Biomedical Research Centre, Asthma UK Centre in Allergic 
      Mechanisms of Asthma, London, UK.
FAU - Schwarze, Jurgen
AU  - Schwarze J
AD  - Centre for Inflammation Research, Child Life and Health, The University of 
      Edinburgh, Edinburgh, UK.
FAU - Canelo-Aybar, Carlos
AU  - Canelo-Aybar C
AD  - Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public 
      Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
AD  - CIBER de Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain.
FAU - Palomares, Oscar
AU  - Palomares O
AUID- ORCID: 0000-0003-4516-0369
AD  - Department of Biochemistry and Molecular Biology, Chemistry School, Complutense 
      University of Madrid, Madrid, Spain.
FAU - Jutel, Marek
AU  - Jutel M
AD  - Department of Clinical Immunology, University of Wroclaw, Wroclaw, Poland.
AD  - ALL-MED" Medical Research Institute, Wroclaw, Poland.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20200401
PL  - Denmark
TA  - Allergy
JT  - Allergy
JID - 7804028
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Biological Products)
RN  - 420K487FSG (dupilumab)
SB  - IM
MH  - Adult
MH  - *Anti-Asthmatic Agents/adverse effects
MH  - Antibodies, Monoclonal, Humanized
MH  - *Asthma/drug therapy
MH  - *Biological Products/therapeutic use
MH  - Child
MH  - Humans
MH  - Quality of Life
OTO - NOTNLM
OT  - cost-effectiveness
OT  - dupilumab
OT  - exacerbations
OT  - oral corticosteroids
OT  - severe asthma
EDAT- 2020/03/11 06:00
MHDA- 2021/05/15 06:00
CRDT- 2020/03/11 06:00
PHST- 2020/02/18 00:00 [received]
PHST- 2020/02/24 00:00 [accepted]
PHST- 2020/03/11 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/03/11 06:00 [entrez]
AID - 10.1111/all.14268 [doi]
PST - ppublish
SO  - Allergy. 2020 May;75(5):1058-1068. doi: 10.1111/all.14268. Epub 2020 Apr 1.