Expert opinion on drug metabolism & toxicology
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Expert Opin Drug Metab Toxicol · Jun 2019
Meta Analysis Comparative StudyMonoclonal antibodies in severe asthma: is it worth it?
Background: To date, there is the strong need to compare the efficacy across the monoclonal antibodies (mAbs) approved to treat severe asthma. Research design and method: A quantitative synthesis has been performed to compare the impact of omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and placebo on the risk of exacerbation and change in forced expiratory flow in 1 s (FEV1) in severe asthmatic patients. Results: All the investigated mAbs were more effective than placebo in reducing the risk of exacerbation and improving lung function. ⋯ The overall-marked placebo effect indicates that a better adherence to drug regimens in the context of RCTs may lead to noteworthy improvement in the clinical condition of severe asthmatic patients. Conclusions: Further extensive meta-analyses are needed to identify the factors influencing the efficacy profile of mAbs in severe asthma. This may also permit to identify the profile of patients that are specifically responsive to either anti-IgE, anti-IL-4Rα, anti-IL-5, or anti-IL-5Rα mAbs.