Efficacy and safety of meperizumab for patients with refractory asthma: a meta-analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LIN Shuang ¹ , CHEN Liping ² ,  YANG Xiaohong ²

1. Xinjiang Medical University, Urumqi, Xinjiang 830000, P. R. China;
2. Department of Respiratory and Critical Care Medicine, Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, Xinjiang 830000, P. R. China;

Corresponding author：

YANG Xiaohong, Email: 2696016545@qq.com

Keywords：

Refractory asthma; meperizumab; safety; meta-analysis

DOI：

10.7507/1671-6205.202111028

Video：

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Objective To evaluate the efficacy and safety of meperizumab for patients with refractory asthma by means of meta-analysis. Methods PubMed, Web of Science, China National Knowledge Infrastructure and other databases were searched for literatures on randomized controlled trials of meperizumab for patients with refractory asthma published before October 30, 2021. The Endnote X9.2 software was used to summarize and eliminate duplicate studies. The literature was screened according to the pre-specified inclusion and exclusion criteria, and data extraction and quality evaluation were performed on the selected literature. Stata 16.0 was used for meta-analysis. Results A total of 632 related articles were detected, and 8 articles were included after screening, including 2438 subjects. Meta-analysis results showed that the patients with refractory asthma treated with meperizumab had a 22% reduction in the risk of exacerbation [relative risk (RR)=0.78, 95% confidence interval (CI) 0.70 to 0.88], forced expiratory volume in one second [weighted mean difference (WMD)=0.10, 95%CI 0.06 to 0.13] and asthma control questionnaire score (WMD=–0.32, 95%CI –0.47 to –0.17) were improved, blood eosinophil count (WMD=–0.23, 95%CI –0.37 to –0.09) and sputum eosinophil count (WMD=–6.37, 95%CI –9.68 to –3.06) were significantly decreased. The probability of serious adverse reactions was significantly reduced (RR=0.65, 95%CI 0.47 to 0.90). Conclusion Meperizumab can effectively reduce the risk of exacerbation for asthma, improve lung function and asthma control level, reduce blood eosinophil count and sputum eosinophil count, and reduce the incidence of serious adverse reactions in patients with refractory asthma.

Citation： LIN Shuang, CHEN Liping, YANG Xiaohong. Efficacy and safety of meperizumab for patients with refractory asthma: a meta-analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(9): 636-642. doi: 10.7507/1671-6205.202111028 Copy

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3.	邓云天. 难治性哮喘的分型研究进展. 国际儿科学杂志, 2021, 48(3): 168-172.
4.	O'Neill S, Sweeney J, Patterson CC, et al. The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax, 2015, 70(4): 376-378.
5.	丛立, 曾云, 陈丽萍, 等. 难治性哮喘不同表型的临床特征与外周血细胞的关系. 中国医药导报, 2019, 16(29): 124-127.
6.	Walsh GM. Recent developments in the use of biologics targeting IL-5, IL-4, or IL-13 in severe refractory asthma. Expert Rev Respir Med, 2018, 12(11): 957-963.
7.	Wu AC, McMahon PM, Welch E, et al. Characteristics of new adult users of mepolizumab with asthma in the USA. BMJ Open Respir Res, 2021, 8(1): e001003.
8.	Chupp GL, Bradford ES, Albers FC, et al. Efficacy of mepolizumab add-on therapy on health-related quality of life and markers of asthma control in severe eosinophilic asthma (MUSCA): a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial. Lancet Respir Med, 2017, 5: 390-400.
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12.	Nair P, Pizzichini MM, Kjarsgaard M, et al. Mepolizumab for prednisone-dependent asthma with sputum eosinophilia. N Engl J Med, 2009, 360(10): 985-993.
13.	Pavord ID, Korn S, Howarth P, et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet, 2012, 380(9842): 651-659.
14.	Ayars AG, Altman LC, Potter-Perigo S, et al. Sputum hyaluronan and versican in severe eosinophilic asthma. Int Arch Allergy Immunol, 2013, 161(1): 65-73.
15.	Bel EH, Wenzel SE, Thompson PJ, et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med, 2014, 371(13): 1189-1197.
16.	Ortega HG, Liu MC, Pavord ID, et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med, 2014, 371(13): 1198-1207.
17.	Lugogo N, Domingo C, Chanez P, et al. Long-term efficacy and safety of mepolizumab in patients with severe eosinophilic asthma: a multi-center, open-label, phase IIIb study. Clin Ther, 2016, 38(9): 2058-2070.e1.
18.	江训盛, 董必文, 张子龙. 支气管热成形术治疗难治性哮喘的疗效与安全性的Meta分析. 中国全科医学, 2019, 22(5): 601-605.
19.	O'Byrne PM. The demise of anti IL-5 for asthma, or not. Am J Respir Crit Care Med, 2007, 176(11): 1059-1060.
20.	苗伟伟, 汪凤凤, 陈子, 等. 奥马珠单抗治疗难治性哮喘疗效的Meta分析. 中国呼吸与危重监护杂志, 2015, 14(5): 449-455.
21.	刘长智, 郑晓滨, 刘茂, 等. 奥马珠单抗治疗难治性哮喘疗效与安全性的Meta分析. 中华临床医师杂志(电子版), 2013, 7(14): 6519-6525.
22.	Flood-Page P, Swenson C, Faiferman I, et al. A study to evaluate safety and efficacy of mepolizumab in patients with moderate persistent asthma. Am J Respir Crit Care Med, 2007, 176(11): 1062-1071.
23.	de Freitas Nakata KC, Marques LD, de Oliveira HC, et al. Anti-interleukin-5 in the management of eosinophilic asthma: a review of effectiveness, safety, and budgetary impact from the perspective of the brazilian health system. Value Health Reg Issues, 2021, 26: 169-181.
24.	江训盛, 周娜, 董必文, 等. 美泊利单抗治疗嗜酸性粒细胞性哮喘疗效与安全性的系统评价. 中国呼吸与危重监护杂志, 2018, 17(1): 6-14.

1. GINA. Difficult-to-treat & sever asthma in adolescent and adult patients diagnosis and management (V3.0 April 2021)[EB/OL]. Available at: https://ginasthma.org/severeasthma/.
2. 林江涛. 难治性哮喘诊断与处理专家共识. 中华结核和呼吸杂志, 2010, 33(8): 572-577.
3. 邓云天. 难治性哮喘的分型研究进展. 国际儿科学杂志, 2021, 48(3): 168-172.
4. O'Neill S, Sweeney J, Patterson CC, et al. The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax, 2015, 70(4): 376-378.
5. 丛立, 曾云, 陈丽萍, 等. 难治性哮喘不同表型的临床特征与外周血细胞的关系. 中国医药导报, 2019, 16(29): 124-127.
6. Walsh GM. Recent developments in the use of biologics targeting IL-5, IL-4, or IL-13 in severe refractory asthma. Expert Rev Respir Med, 2018, 12(11): 957-963.
7. Wu AC, McMahon PM, Welch E, et al. Characteristics of new adult users of mepolizumab with asthma in the USA. BMJ Open Respir Res, 2021, 8(1): e001003.
8. Chupp GL, Bradford ES, Albers FC, et al. Efficacy of mepolizumab add-on therapy on health-related quality of life and markers of asthma control in severe eosinophilic asthma (MUSCA): a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial. Lancet Respir Med, 2017, 5: 390-400.
9. Menzella F, Galeone C, Lusuardi M, et al. Near-fatal asthma responsive to mepolizumab after failure of omalizumab and bronchial thermoplasty. Ther Clin Risk Manag, 2017, 13: 1489-1493.
10. Cumpston M, Li TJ, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev, 2019, 10: ED000142.
11. Haldar P, Brightling CE, Hargadon B, et al. Mepolizumab and exacerbations of refractory eosinophilic asthma. N Engl J Med, 2009, 360(10): 973-984.
12. Nair P, Pizzichini MM, Kjarsgaard M, et al. Mepolizumab for prednisone-dependent asthma with sputum eosinophilia. N Engl J Med, 2009, 360(10): 985-993.
13. Pavord ID, Korn S, Howarth P, et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet, 2012, 380(9842): 651-659.
14. Ayars AG, Altman LC, Potter-Perigo S, et al. Sputum hyaluronan and versican in severe eosinophilic asthma. Int Arch Allergy Immunol, 2013, 161(1): 65-73.
15. Bel EH, Wenzel SE, Thompson PJ, et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med, 2014, 371(13): 1189-1197.
16. Ortega HG, Liu MC, Pavord ID, et al. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med, 2014, 371(13): 1198-1207.
17. Lugogo N, Domingo C, Chanez P, et al. Long-term efficacy and safety of mepolizumab in patients with severe eosinophilic asthma: a multi-center, open-label, phase IIIb study. Clin Ther, 2016, 38(9): 2058-2070.e1.
18. 江训盛, 董必文, 张子龙. 支气管热成形术治疗难治性哮喘的疗效与安全性的Meta分析. 中国全科医学, 2019, 22(5): 601-605.
19. O'Byrne PM. The demise of anti IL-5 for asthma, or not. Am J Respir Crit Care Med, 2007, 176(11): 1059-1060.
20. 苗伟伟, 汪凤凤, 陈子, 等. 奥马珠单抗治疗难治性哮喘疗效的Meta分析. 中国呼吸与危重监护杂志, 2015, 14(5): 449-455.
21. 刘长智, 郑晓滨, 刘茂, 等. 奥马珠单抗治疗难治性哮喘疗效与安全性的Meta分析. 中华临床医师杂志(电子版), 2013, 7(14): 6519-6525.
22. Flood-Page P, Swenson C, Faiferman I, et al. A study to evaluate safety and efficacy of mepolizumab in patients with moderate persistent asthma. Am J Respir Crit Care Med, 2007, 176(11): 1062-1071.
23. de Freitas Nakata KC, Marques LD, de Oliveira HC, et al. Anti-interleukin-5 in the management of eosinophilic asthma: a review of effectiveness, safety, and budgetary impact from the perspective of the brazilian health system. Value Health Reg Issues, 2021, 26: 169-181.
24. 江训盛, 周娜, 董必文, 等. 美泊利单抗治疗嗜酸性粒细胞性哮喘疗效与安全性的系统评价. 中国呼吸与危重监护杂志, 2018, 17(1): 6-14.

Chinese Journal of Respiratory and Critical Care Medicine

Efficacy and safety of meperizumab for patients with refractory asthma: a meta-analysis

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