{"title":"Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis.","authors":"Christos Kyriakopoulos, Efthymia Papadopoulou, Dimitrios Potonos, Konstantinos Exarchos, Evangelos Beris, Christina Aggelopoulou, Stavros Tryfon, Athena Gogali, Konstantinos Kostikas","doi":"10.1183/23120541.00625-2024","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Three biologics targeting interleukin 5 (anti-IL-5) or its receptor-α (anti-IL-5Rα) are approved for patients with severe asthma.</p><p><strong>Methods: </strong>We systematically searched the literature published in Medline and Embase up to 1 May 2023 to identify observational studies and nonrandomised trials that assess the response to anti-IL-5/5Rα in real-life patients with severe eosinophilic asthma. We also performed random-effects meta-analyses.</p><p><strong>Results: </strong>We identified 6401 studies, of which 92 with 9546 patients were analysed. Biologics use was associated with a 62% reduction in severe exacerbations (risk ratio 0.38, 95% CI 0.29-0.50) and a 54% reduction in hospitalisations (risk ratio 0.46, 95% CI 0.35-0.61) at 12 months of treatment, compared to pre-treatment. Biologics improved asthma control (decrease in asthma control questionnaire score by 1.11 points (95% CI -1.29--0.94) and increase in asthma control test score by 6.41 points (95% CI 5.66-7.16)) and increased the asthma quality of life questionnaire score by 1.08 points (95% CI 0.88-1.28) and forced expiratory volume in 1 s by 0.21 L (95% CI 0.15-0.27) at 12 months. There was a significant reduction in oral corticosteroids use of 51% (risk ratio 0.49, 95% CI 0.42-0.56), with a mean dose reduction of 6.01 mg·day<sup>-1</sup> (95% CI -7.55--4.48) at 12 months of treatment. Similar findings were observed at 3-4, 6 and 24 months. A biomarker-related response to treatment was also noted.</p><p><strong>Conclusions: </strong>This comprehensive meta-analysis summarises the significant clinical response to anti-IL-5/5Rα biologics in real-life studies, providing important insights for their use in clinical practice.</p>","PeriodicalId":11739,"journal":{"name":"ERJ Open Research","volume":"11 2","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931541/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ERJ Open Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1183/23120541.00625-2024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Three biologics targeting interleukin 5 (anti-IL-5) or its receptor-α (anti-IL-5Rα) are approved for patients with severe asthma.
Methods: We systematically searched the literature published in Medline and Embase up to 1 May 2023 to identify observational studies and nonrandomised trials that assess the response to anti-IL-5/5Rα in real-life patients with severe eosinophilic asthma. We also performed random-effects meta-analyses.
Results: We identified 6401 studies, of which 92 with 9546 patients were analysed. Biologics use was associated with a 62% reduction in severe exacerbations (risk ratio 0.38, 95% CI 0.29-0.50) and a 54% reduction in hospitalisations (risk ratio 0.46, 95% CI 0.35-0.61) at 12 months of treatment, compared to pre-treatment. Biologics improved asthma control (decrease in asthma control questionnaire score by 1.11 points (95% CI -1.29--0.94) and increase in asthma control test score by 6.41 points (95% CI 5.66-7.16)) and increased the asthma quality of life questionnaire score by 1.08 points (95% CI 0.88-1.28) and forced expiratory volume in 1 s by 0.21 L (95% CI 0.15-0.27) at 12 months. There was a significant reduction in oral corticosteroids use of 51% (risk ratio 0.49, 95% CI 0.42-0.56), with a mean dose reduction of 6.01 mg·day-1 (95% CI -7.55--4.48) at 12 months of treatment. Similar findings were observed at 3-4, 6 and 24 months. A biomarker-related response to treatment was also noted.
Conclusions: This comprehensive meta-analysis summarises the significant clinical response to anti-IL-5/5Rα biologics in real-life studies, providing important insights for their use in clinical practice.
背景：三种靶向白介素5（抗il -5）或其受体-α（抗il - 5r α）的生物制剂已被批准用于重度哮喘患者。方法：我们系统地检索了截至2023年5月1日在Medline和Embase上发表的文献，以确定评估现实生活中严重嗜酸性哮喘患者抗il -5/ 5r α反应的观察性研究和非随机试验。我们还进行了随机效应荟萃分析。结果：我们确定了6401项研究，其中92项涉及9546例患者进行了分析。与治疗前相比，生物制剂的使用与治疗12个月时严重恶化发生率降低62%（风险比0.38,95% CI 0.29-0.50）和住院率降低54%（风险比0.46,95% CI 0.35-0.61）相关。生物制剂改善哮喘控制（哮喘控制问卷评分降低1.11分（95% CI -1.29—0.94），哮喘控制测试评分提高6.41分（95% CI 5.66—7.16）），哮喘生活质量问卷评分提高1.08分（95% CI 0.88—1.28），12个月时1 s强迫呼气量增加0.21 L （95% CI 0.15—0.27）。口服皮质类固醇的使用显著减少51%（风险比0.49,95% CI 0.42-0.56），治疗12个月时平均剂量减少6.01 mg·day-1 （95% CI -7.55- 4.48）。在3-4个月、6个月和24个月时观察到类似的结果。还注意到与生物标志物相关的治疗反应。结论：这项综合荟萃分析总结了现实研究中抗il -5/ 5r α生物制剂的显著临床反应，为其在临床实践中的应用提供了重要见解。
期刊介绍：
ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.
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