Reslizumab versus placebo for poorly controlled, severe eosinophilic asthma: Meta-analysis

Milos Milosavljevic, Slobodan Jankovic, Ana Pejcic, Jasmina Milovanovic, Valentina Opancina, Marina Kostic
2017 Vojnosanitetski Pregled  
Background/Aim. Reslizumab is humanized monoclonal antibody produced by recombinant DNA technology which binds to circulating interleukin-5 (IL-5) and down-regulates the IL-5 signaling pathway. Reslizumab is indicated for the add-on maintenance treatment of patients 18 years and older with severe eosinophilic asthma phenotype whose symptoms were inadequately controlled with inhaled corticosteroids. The aim of this meta-analysis was to assess the efficacy and safety of reslizumab compared to
more » ... ebo in patients suffering from inadequately controlled, moderateto-severe asthma with elevated blood eosinophil counts. Methods. Our meta-analysis was based on systematic search of literature and selection of high-quality evidence according to pre-set inclusion and exclusion criteria. The effects of reslizumab and placebo were summarized using Review Manager (RevMan) 5.3.5 and heterogeneity was assessed by the Cochrane Q test and I² values. Several types of bias were assessed and publication bias shown by Funnel plot and Egger's regression. Results. The meta-analysis in-cluded 5 randomized, placebo-controlled clinical trials. Reslizumab 3.0 mg/kg produced substantial improvements in forced expiratory volume in 1. second (FEV 1) (mean difference 0.15 [0.10, 0.21]) and in forced vital capacity (FVC) (mean difference 0.21 [0.09, 0.32]) over the 15 or 16-week treatment period, substantial decrease versus placebo in Asthma Control Questionnaire (ACQ) score (mean difference -0.28 [-0.41, -0.16]), and substantial increase vs. placebo from baseline in Asthma Quality of Life Questionnaire (AQLQ) total score (mean difference 0.24 [0.06, 0.43]). Also, reslizumab 3.0 mg/kg caused less adverse events versus placebo (OR 0.67 [0.51, 0.88]), especially asthma worsening (OR 0.53 [0.36, 0.77]) or bronchitis (OR 0.42 [0.24, 0.74]). Conclusion. On the basis of published clinical trials reslizumab could be considered as an effective and safe therapeutic option for severe, poorly controlled eosinophilic asthma for the time being. Apstrakt Milosavljević NM, et al. Vojnosanit Pregl 2018; 75(9): 884-896. odnosu na placebo (OR 0,67 [0,51, 0,88]), posebno kada je u pitanju pogoršanje astme (OR 0,53 [0,36, 0,77]) ili bronhitis (OR 0,42 [0, 24, 0,74]). Zaključak. Na osnovu publikovanih kliničkih studija reslizumab se može smatrati efikasnom i bezbednom terapijskom opcijom kod bolesnika sa teškom, neade-kvatno kontrolisanom eozinofilnom astmom.
doi:10.2298/vsp161124013m fatcat:cmuj7qa22zhflfmabq3spglzlm