TY - JOUR
T1 - Reslizumab Compared with Benralizumab in Patients with Eosinophilic Asthma
T2 - A Systematic Literature Review and Network Meta-Analysis
AU - Casale, Thomas B.
AU - Pacou, Maud
AU - Mesana, Laura
AU - Farge, Gaelle
AU - Sun, Shawn X.
AU - Castro, Mario
N1 - Publisher Copyright:
© 2019 American Academy of Allergy, Asthma & Immunology
PY - 2019/1
Y1 - 2019/1
N2 - Background: The interaction of IL-5 with its receptor on eosinophils increases the activation and maintenance of eosinophils; blocking this interaction reduces asthma symptoms in patients with the eosinophilic phenotype. Reslizumab, which binds to IL-5, and benralizumab, which targets the IL-5 receptor α subunit, have not been compared in head-to-head trials. Objective: To indirectly compare reslizumab with benralizumab in similar patient populations using a network meta-analysis. Methods: A systematic literature review was conducted and a network meta-analysis was performed on eligible studies using the Markov Chain Monte-Carlo simulation method and a Bayesian statistical framework. Results: Eleven studies were identified, 4 of which evaluated clinically relevant doses and had outcomes at similar time points. To control for population differences, subgroups were selected for the base-case efficacy analysis: a benralizumab subgroup with blood eosinophil levels of greater than or equal to 300 cells/μL (n = 1537) and a reslizumab subgroup in Global Initiative for Asthma step 4/5 with 2 or more previous exacerbations and greater than or equal to 400 eosinophils/μL (n = 318). Safety was analyzed in the full population (N = 3462). Reslizumab significantly improved Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ) scores compared with benralizumab once every 4 weeks and there were reasonably high posterior probabilities that reslizumab is superior to benralizumab once every 4 weeks and once every 8 weeks for ACQ score, AQLQ score, FEV1, and clinical asthma exacerbations. Conclusions: This indirect comparison suggests that reslizumab may be more efficacious than benralizumab in patients with eosinophilic asthma in Global Initiative for Asthma step 4/5 with elevated blood eosinophil levels (benralizumab, ≥300/μL; reslizumab, ≥400/μL) and 2 or more exacerbations in the previous year.
AB - Background: The interaction of IL-5 with its receptor on eosinophils increases the activation and maintenance of eosinophils; blocking this interaction reduces asthma symptoms in patients with the eosinophilic phenotype. Reslizumab, which binds to IL-5, and benralizumab, which targets the IL-5 receptor α subunit, have not been compared in head-to-head trials. Objective: To indirectly compare reslizumab with benralizumab in similar patient populations using a network meta-analysis. Methods: A systematic literature review was conducted and a network meta-analysis was performed on eligible studies using the Markov Chain Monte-Carlo simulation method and a Bayesian statistical framework. Results: Eleven studies were identified, 4 of which evaluated clinically relevant doses and had outcomes at similar time points. To control for population differences, subgroups were selected for the base-case efficacy analysis: a benralizumab subgroup with blood eosinophil levels of greater than or equal to 300 cells/μL (n = 1537) and a reslizumab subgroup in Global Initiative for Asthma step 4/5 with 2 or more previous exacerbations and greater than or equal to 400 eosinophils/μL (n = 318). Safety was analyzed in the full population (N = 3462). Reslizumab significantly improved Asthma Control Questionnaire (ACQ) and Asthma Quality of Life Questionnaire (AQLQ) scores compared with benralizumab once every 4 weeks and there were reasonably high posterior probabilities that reslizumab is superior to benralizumab once every 4 weeks and once every 8 weeks for ACQ score, AQLQ score, FEV1, and clinical asthma exacerbations. Conclusions: This indirect comparison suggests that reslizumab may be more efficacious than benralizumab in patients with eosinophilic asthma in Global Initiative for Asthma step 4/5 with elevated blood eosinophil levels (benralizumab, ≥300/μL; reslizumab, ≥400/μL) and 2 or more exacerbations in the previous year.
KW - Asthma
KW - Eosinophil
KW - IL-5
KW - Indirect comparison
KW - mAbs
UR - http://www.scopus.com/inward/record.url?scp=85054453175&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2018.08.036
DO - 10.1016/j.jaip.2018.08.036
M3 - Article
C2 - 30217529
AN - SCOPUS:85054453175
SN - 2213-2198
VL - 7
SP - 122-130.e1
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 1
ER -