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 - Funding Information:
Conflicts of interest: T. B. Casale has received support for travel, consultant fees, and grants from Teva Pharmaceuticals and serves as Executive VP of the American Academy of Allergy, Asthma & Immunology. S. X. Sun is currently employed by and has stock/stock options with Teva Pharmaceuticals. M. Castro is a paid consultant for Holaira, Sanofi-Aventis, and Aviragen; serves as a consultant and speaker for Boston Scientific, Genentech, and Teva Pharmaceuticals; has received compensation for industry-sponsored studies from Teva Pharmaceuticals, GlaxoSmithKline, Sanofi-Aventis, Vectura, Boehringer Ingelheim, Invion, AstraZeneca, Gilead, Novartis, and Chiesi; serves as a speaker for Boehringer Ingelheim and AstraZeneca; receives royalties from Elsevier, serves as a member of the Data Safety Monitoring Committee for GlaxoSmithKline; and has received grant money from the National Institutes of Health. The rest of the authors declare that they have no relevant conflicts of interest.
Funding Information:
This study was sponsored by Teva Pharmaceuticals. Medical writing support was provided by William Watkins of StemScientific (an Ashfield company, part of UDG Healthcare plc), and was funded by Teva Pharmaceuticals (Frazer, Pa) during the preparation of this manuscript. Teva provided a full review of the article. The authors were fully responsible for all content and editorial decisions, and were involved at all stages of manuscript development.Conflicts of interest: T. B. Casale has received support for travel, consultant fees, and grants from Teva Pharmaceuticals and serves as Executive VP of the American Academy of Allergy, Asthma & Immunology. S. X. Sun is currently employed by and has stock/stock options with Teva Pharmaceuticals. M. Castro is a paid consultant for Holaira, Sanofi-Aventis, and Aviragen; serves as a consultant and speaker for Boston Scientific, Genentech, and Teva Pharmaceuticals; has received compensation for industry-sponsored studies from Teva Pharmaceuticals, GlaxoSmithKline, Sanofi-Aventis, Vectura, Boehringer Ingelheim, Invion, AstraZeneca, Gilead, Novartis, and Chiesi; serves as a speaker for Boehringer Ingelheim and AstraZeneca; receives royalties from Elsevier, serves as a member of the Data Safety Monitoring Committee for GlaxoSmithKline; and has received grant money from the National Institutes of Health. The rest of the authors declare that they have no relevant conflicts of interest.
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 -