Efficacy and safety of dupilumab for the treatment of uncontrolled asthma: a meta-analysis of randomized clinical trials

• Published in: Respiratory research Vol. 20; no. 1; p. 108
• Main Authors: Xiong, Xiao-Feng, Zhu, Min, Wu, Hong-Xia, Fan, Li-Li, Cheng, De-Yun
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 31.05.2019; BioMed Central; BMC
• Subjects: Anti-Asthmatic Agents - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Asthma; Asthma - diagnosis; Asthma - drug therapy; Asthma - physiopathology; Clinical trials; Collaboration; Control methods; Cytokines; Drug therapy; Dupilumab; Emergency medical care; Humans; Immunotherapy; Medical research; Meta-analysis; Monoclonal antibodies; Patient outcomes; Patients; Pharmaceutical research; Quality of life; Questionnaires; Randomization; Randomized control trial; Randomized Controlled Trials as Topic - methods; Respiratory Function Tests - methods; Risk assessment; Safety; Signs and symptoms; Studies; Treatment Outcome; Uncontrolled asthma; China; Dupilumab; Randomized control trial; Uncontrolled asthma; Meta-analysis
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-019-1065-3

Several recent clinical trials have assessed the effects of dupilumab in uncontrolled asthma, but reached no definite conclusion. We therefore conducted this meta-analysis to evaluate the overall efficacy and safety of dupilumab for the treatment of uncontrolled asthma. All randomized controlled trials were included. Standard mean differences (SMD) or relative risks (RR) were calculated using Fixed-or random-effects models. Five studies involving 3369 patients were identified. Pooled analysis showed significant improvements in the first-second forced expiratory volume (FEV ) (SMD = 4.29, 95% CI: 2.78-5.81) and Asthma Quality of Life Questionnaire scores (SMD = 4.39, 95% CI: 1.44-7.34). Dupilumab treatments were also associated with significantly decreased 5-item Asthma Control Questionnaire scores (SMD = - 4.95, 95% CI: - 7.30 to - 2.60), AM and PM asthma symptom scores (SMD = - 5.09, 95% CI: - 6.40 to - 3.77; SMD = - 4.92, 95% CI: - 5.98 to - 3.86, respectively), and severe exacerbation risk (RR = 0.73; 95% CI: 0.67-0.79) compared with placebo, with similar incidence of adverse events (RR = 1.0; 95% CI: 0.96-1.04). Dupilumab treatment is relatively well-tolerated and could significantly improve FEV , symptoms, asthma control, and quality of life, and reduced severe exacerbation risk in patients with uncontrolled asthma.