Results of a recently published meta-analysis concluded that the majority of new biologics used in the treatment of eosinophilic asthma improve several clinical outcomes compared to placebo.
PubMed was searched to obtain data on the relative efficacies of benralizumab, dupilumab, lebrikizumab, mepolizumab, reslizumab, and tralokinumab. Study endpoints included forced expiratory volume-in 1 s (FEV1) changes, asthma control questionnaire (ACQ), and asthma quality of life questionnaire (AQLQ). Additionally, annualized rate ratios for asthma exacerbations were calculated for each medication and were compared to placebo.
Results of the analysis concluded that all medications, except tralokinumab, were superior in all outcomes evaluated compared to placebo. Dupilumab was found to have the greatest increase in FEV1 compared to placebo (0.16L; 95% CI: 0.08, 0.24), followed by reslizumab (0.13L; 95% CI: 0.10, 0.17) and benralizumab (0.12L; 95% CI: 0.08, 0.17).
“While mepolizumab, followed by dupliumab, benralizumab, and reslizumab showed reductions in ACQ scores, in order of magnitude of effect, dupilumab, followed by mepolizumab, benralizumab, and reslizumab showed the greatest increase in AQLQ scores,” the study authors reported. Additionally, all medications decreased the number of asthma exacerbations, however, the results were statistically significant for reslizumab and dupilumab only.
The study authors concluded, “All drugs except for tralokinumab showed improvements in FEV1, ACQ, and AQLQ.” They added, “Only reslizumab and dupilumab were associated with statistically significant reductions in asthma exacerbation rates.”
Iftikhar IH, Schimmel M, Bender W, Swenson C, Amrol D. Comparative Efficacy of Anti IL-4, IL-5 and IL-13 Drugs for Treatment of Eosinophilic Asthma: A Network Meta-analysis. Lung, 2018. DOI.org/10.1007/s00408-018-0151-5.