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

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.	林江濤. 難治性哮喘診斷與處理專家共識. 中華結核和呼吸雜志, 2010, 33(8): 572-577.
3.	鄧云天. 難治性哮喘的分型研究進展. 國際兒科學雜志, 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.	叢立, 曾云, 陳麗萍, 等. 難治性哮喘不同表型的臨床特征與外周血細胞的關系. 中國醫藥導報, 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.
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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.	江訓盛, 董必文, 張子龍. 支氣管熱成形術治療難治性哮喘的療效與安全性的Meta分析. 中國全科醫學, 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.	苗偉偉, 汪鳳鳳, 陳子, 等. 奧馬珠單抗治療難治性哮喘療效的Meta分析. 中國呼吸與危重監護雜志, 2015, 14(5): 449-455.
21.	劉長智, 鄭曉濱, 劉茂, 等. 奧馬珠單抗治療難治性哮喘療效與安全性的Meta分析. 中華臨床醫師雜志(電子版), 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.	江訓盛, 周娜, 董必文, 等. 美泊利單抗治療嗜酸性粒細胞性哮喘療效與安全性的系統評價. 中國呼吸與危重監護雜志, 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. 林江濤. 難治性哮喘診斷與處理專家共識. 中華結核和呼吸雜志, 2010, 33(8): 572-577.
3. 鄧云天. 難治性哮喘的分型研究進展. 國際兒科學雜志, 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. 叢立, 曾云, 陳麗萍, 等. 難治性哮喘不同表型的臨床特征與外周血細胞的關系. 中國醫藥導報, 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. 江訓盛, 董必文, 張子龍. 支氣管熱成形術治療難治性哮喘的療效與安全性的Meta分析. 中國全科醫學, 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. 苗偉偉, 汪鳳鳳, 陳子, 等. 奧馬珠單抗治療難治性哮喘療效的Meta分析. 中國呼吸與危重監護雜志, 2015, 14(5): 449-455.
21. 劉長智, 鄭曉濱, 劉茂, 等. 奧馬珠單抗治療難治性哮喘療效與安全性的Meta分析. 中華臨床醫師雜志(電子版), 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. 江訓盛, 周娜, 董必文, 等. 美泊利單抗治療嗜酸性粒細胞性哮喘療效與安全性的系統評價. 中國呼吸與危重監護雜志, 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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