Efficacy and safety of benralizumab in eosinophilic granulomatosis with polyangiitis: A meta-analysis of eight studies.

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Federico Spataro, Antonio Giovanni Solimando, Attilio Di Girolamo, Angelo Vacca, Roberto Ria
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引用次数: 0

Abstract

Objective: Eosinophilic granulomatous polyangiitis (EGPA) is a rare autoimmune disease characterized by multisystemic inflammation, with eosinophils playing a central role in its pathogenesis. Traditional management relies heavily on corticosteroids and immunosuppressants, which are associated with significant side effects. The emergence of biologic agents, such as benralizumab, offers targeted therapeutic options by inhibiting the interleukin-5 receptor α, thereby reducing eosinophilic inflammation.

Methods: This systematic review and meta-analysis comprehensively evaluate the efficacy and safety of benralizumab in EGPA patients, focusing on its ability to reduce oral corticosteroid (OCS) use, facilitate remission and spare immunosuppressants. We searched MEDLINE, LILACS and ISI Web of Science databases for relevant studies up to July 2024.

Results: Eight studies, including both randomized controlled trials (RCTs) and observational studies, were included in the meta-analysis, involving a total of 396 EGPA patients. The pooled analysis demonstrated a significant reduction in OCS dose, with an overall estimated effect of -8.25 mg/day (95% CI, -9.39 to -7.10). Complete remission was achieved in 56.8% of patients, and immunosuppressants were reduced or discontinued in 28.1% of cases. Adverse events (AEs) were reported in 21.9% of patients, with only one discontinuation due to an AE.

Conclusion: These findings provide robust evidence supporting the use of benralizumab as an effective and well-tolerated treatment option for EGPA, significantly reducing OCS requirements and offering promising remission rates. Future research should focus on larger, multicentre RCTs to confirm these findings and further elucidate the long-term benefits and safety profile of benralizumab in EGPA.

苯拉利珠单抗治疗嗜酸性粒细胞肉芽肿伴多血管炎的疗效和安全性:八项研究的荟萃分析。
目的:嗜酸性粒细胞肉芽肿性多血管炎(EGPA)是一种罕见的自身免疫性疾病,以多系统炎症为特征,嗜酸性粒细胞在其发病机制中起着核心作用。传统的治疗方法主要依赖皮质类固醇和免疫抑制剂,但副作用很大。benralizumab等生物制剂的出现通过抑制白细胞介素-5受体α,从而减轻嗜酸性粒细胞炎症,提供了靶向治疗选择:本系统综述和荟萃分析全面评估了苯拉利珠单抗对 EGPA 患者的疗效和安全性,重点关注其减少口服皮质类固醇(OCS)用量、促进病情缓解和避免使用免疫抑制剂的能力。我们检索了MEDLINE、LILACS和ISI Web of Science数据库中截至2024年7月的相关研究:荟萃分析纳入了八项研究,包括随机对照试验(RCT)和观察性研究,共涉及 396 名 EGPA 患者。汇总分析表明,OCS剂量显著减少,总体估计效果为-8.25毫克/天(95% CI,-9.39至-7.10)。56.8%的患者获得了完全缓解,28.1%的病例减少或停用了免疫抑制剂。21.9%的患者出现了不良事件(AE),只有1例患者因AE而停药:这些研究结果提供了有力的证据,支持使用苯拉利珠单抗作为治疗EGPA的一种有效且耐受性良好的治疗方案,可显著减少OCS需求,并提供可喜的缓解率。未来的研究应侧重于更大规模的多中心 RCT,以证实这些发现,并进一步阐明 Benralizumab 治疗 EGPA 的长期疗效和安全性。
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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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