Efficacy and safety of biologics in children and adolescents with eosinophilic asthma: A systematic review and meta-Analysis.

IF 2.1 4区医学 Q3 ALLERGY

Asian Pacific journal of allergy and immunology Pub Date : 2026-09-01 DOI:10.12932/AP-151025-2164

Yulin Geng, Junmei Xu

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引用次数: 0

Abstract

Background: Eosinophilic asthma is a severe phenotype in pediatrics, often refractory to conventional therapy. Biologic agents targeting Type 2 inflammatory pathway are increasingly used in children and adolescents.

Objective: To evaluate the efficacy and safety of omalizumab, mepolizumab, benralizumab, and dupilumab in pediatric eosinophilic asthma.

Methods: We systematically searched eight databases to March 31, 2025 (PROSPERO: CRD420251017602). Eligible studies were randomized controlled or controlled observational trials in patients 1≤8 years. Outcomes included lung function, asthma control, quality of life (QoL), and adverse events (AEs).

Results: Twenty-two studies (n = 2,468) were included. Biologics significantly improved predicted FEV1 (SMD = 0.97, 95%CI: 0.38-1.57), asthma control also improved (SMD = 2.84, 95%CI: 1.40-4.28), as did quality of life (SMD = 1.72, 95%CI: 0.39-3.05). Overall AEs were more frequent (OR 1.48, 95%CI 1.22-1.81), but serious AEs were rare and not increased. Evidence was strongest for omalizumab; data for other biologics remain limited.

Conclusions: Biologic therapies are associated with improvements in clinical outcomes in children and adolescents with eosinophilic asthma, with an increased incidence of predominantly mild adverse events. However, the current evidence is largely driven by studies of omalizumab, and data for other biologics remain limited in pediatric populations. Further long-term and comparative studies are warranted to better define the efficacy and safety profiles of individual biologic agents.

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生物制剂治疗儿童和青少年嗜酸性粒细胞哮喘的疗效和安全性：一项系统综述和荟萃分析。

背景：嗜酸性粒细胞性哮喘是儿科中一种严重的表型，通常难以常规治疗。针对2型炎症通路的生物制剂越来越多地用于儿童和青少年。目的：评价omalizumab、mepolizumab、benralizumab和dupilumab治疗小儿嗜酸性粒细胞哮喘的疗效和安全性。方法：系统检索8个数据库至2025年3月31日（PROSPERO: CRD420251017602）。符合条件的研究是1年≤8年患者的随机对照或对照观察性试验。结果包括肺功能、哮喘控制、生活质量（QoL）和不良事件（ae）。结果：纳入22项研究（n = 2468）。生物制剂显著改善预测FEV1 (SMD = 0.97, 95%CI: 0.38-1.57)，哮喘控制也得到改善（SMD = 2.84, 95%CI: 1.40-4.28），生活质量也得到改善（SMD = 1.72, 95%CI: 0.39-3.05）。总体ae发生率较高（OR为1.48,95%CI为1.22 ~ 1.81），但严重ae发生率较低且未升高。omalizumab的证据最强；其他生物制剂的数据仍然有限。结论：生物治疗与儿童和青少年嗜酸性粒细胞性哮喘的临床结果改善相关，主要是轻微不良事件的发生率增加。然而，目前的证据主要是由omalizumab的研究驱动的，其他生物制剂在儿科人群中的数据仍然有限。为了更好地确定单个生物制剂的疗效和安全性，有必要进行进一步的长期和比较研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Pacific journal of allergy and immunology 医学-过敏

CiteScore

12.80

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747 APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume. APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand. The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.