Departmental Bulletin Paper Anti-interleukin-13, a Monoclonal Antibody, in Uncontrolled Asthma: Systematic Review and Meta-analysis

ANDO Koichi:筆頭著者:責任著者  ,  TANAKA Akihiko  ,  HOMMA Tetsuya  ,  OHNISHI Tsukasa  ,  INOUE Shin  ,  SAGARA Hironori

29 ( 4 )  , pp.353 - 364 , 2017-12 , Showa University Society
The overall efficacy and safety of anti-interleukin (IL)-13 therapies remain to be fully characterized. We conducted a meta-analysis of randomized controlled trials (RCTs) on the efficacy and safety of anti-IL-13 therapies compared with placebo in patients with uncontrolled asthma. This meta-analysis complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary efficacy outcome was pulmonary function, and the primary safety outcome was the incidence rate of all adverse events (AAEs). Secondary outcomes included asthma exacerbation, asthma control, and asthma-related quality of life (QoL). Pooled estimates are presented as mean differences (MDs), hazard ratios (HRs) or risk ratios (RRs) with 95% confidence intervals (CIs). Five RCTs of anti-IL-13 therapies, including tralokinumab, GSK679586, or lebrikizumab, met the criteria for study inclusion. The overall MD for change in forced expiratory volume in 1 second was 0.08 (95% CI 0.02, 0.15). The RR for the incidence of AAEs compared with placebo was 1.03 (95% CI 0.86, 1.25). The time to first exacerbation improved significantly in the anti-IL-13 compared with placebo group (HR 0.69; 95% CI 0.55, 0.87). Analysis of asthma control and asthma-related QoL revealed significant improvements in the Asthma Control Questionnaire-6 and Asthma Quality of Life Questionnaire scores among anti-IL-13-compared with placebo-treated patients, with MDs of −0.17 (95% CI −0.29, −0.04) and 0.19 (95% CI 0.08, 0.31), respectively. These results strongly indicate that anti-IL-13 therapies are effective and generally well tolerated in patients with uncontrolled asthma.

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