Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis
Background Three biologics targeting interleukin 5 (anti-IL-5) or its receptor-α (anti-IL-5Rα) are approved for patients with severe asthma. Methods We systematically searched the literature published in Medline and Embase up to 1 May 2023 to identify observational studies and nonrandomised trials t...
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2025-03-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/11/2/00625-2024.full |
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| author | Christos Kyriakopoulos Efthymia Papadopoulou Dimitrios Potonos Konstantinos Exarchos Evangelos Beris Christina Aggelopoulou Stavros Tryfon Athena Gogali Konstantinos Kostikas |
| author_facet | Christos Kyriakopoulos Efthymia Papadopoulou Dimitrios Potonos Konstantinos Exarchos Evangelos Beris Christina Aggelopoulou Stavros Tryfon Athena Gogali Konstantinos Kostikas |
| author_sort | Christos Kyriakopoulos |
| collection | DOAJ |
| description | Background
Three biologics targeting interleukin 5 (anti-IL-5) or its receptor-α (anti-IL-5Rα) are approved for patients with severe asthma.
Methods
We systematically searched the literature published in Medline and Embase up to 1 May 2023 to identify observational studies and nonrandomised trials that assess the response to anti-IL-5/5Rα in real-life patients with severe eosinophilic asthma. We also performed random-effects meta-analyses.
Results
We identified 6401 studies, of which 92 with 9546 patients were analysed. Biologics use was associated with a 62% reduction in severe exacerbations (risk ratio 0.38, 95% CI 0.29–0.50) and a 54% reduction in hospitalisations (risk ratio 0.46, 95% CI 0.35–0.61) at 12 months of treatment, compared to pre-treatment. Biologics improved asthma control (decrease in asthma control questionnaire score by 1.11 points (95% CI −1.29–−0.94) and increase in asthma control test score by 6.41 points (95% CI 5.66–7.16)) and increased the asthma quality of life questionnaire score by 1.08 points (95% CI 0.88–1.28) and forced expiratory volume in 1 s by 0.21 L (95% CI 0.15–0.27) at 12 months. There was a significant reduction in oral corticosteroids use of 51% (risk ratio 0.49, 95% CI 0.42–0.56), with a mean dose reduction of 6.01 mg·day−1 (95% CI −7.55–−4.48) at 12 months of treatment. Similar findings were observed at 3–4, 6 and 24 months. A biomarker-related response to treatment was also noted.
Conclusions
This comprehensive meta-analysis summarises the significant clinical response to anti-IL-5/5Rα biologics in real-life studies, providing important insights for their use in clinical practice. |
| format | Article |
| id | doaj-art-62cfcf0e06e04cc09fe6cfba911faf12 |
| institution | OA Journals |
| issn | 2312-0541 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj-art-62cfcf0e06e04cc09fe6cfba911faf122025-08-20T02:14:45ZengEuropean Respiratory SocietyERJ Open Research2312-05412025-03-0111210.1183/23120541.00625-202400625-2024Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysisChristos Kyriakopoulos0Efthymia Papadopoulou1Dimitrios Potonos2Konstantinos Exarchos3Evangelos Beris4Christina Aggelopoulou5Stavros Tryfon6Athena Gogali7Konstantinos Kostikas8 Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Respiratory Medicine Department, General Hospital of Thessaloniki G Papanikolaou, Thessaloniki, Greece Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Respiratory Medicine Department, General Hospital of Thessaloniki G Papanikolaou, Thessaloniki, Greece Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Respiratory Medicine Department, Faculty of Medicine, University of Ioannina, Ioannina, Greece Background Three biologics targeting interleukin 5 (anti-IL-5) or its receptor-α (anti-IL-5Rα) are approved for patients with severe asthma. Methods We systematically searched the literature published in Medline and Embase up to 1 May 2023 to identify observational studies and nonrandomised trials that assess the response to anti-IL-5/5Rα in real-life patients with severe eosinophilic asthma. We also performed random-effects meta-analyses. Results We identified 6401 studies, of which 92 with 9546 patients were analysed. Biologics use was associated with a 62% reduction in severe exacerbations (risk ratio 0.38, 95% CI 0.29–0.50) and a 54% reduction in hospitalisations (risk ratio 0.46, 95% CI 0.35–0.61) at 12 months of treatment, compared to pre-treatment. Biologics improved asthma control (decrease in asthma control questionnaire score by 1.11 points (95% CI −1.29–−0.94) and increase in asthma control test score by 6.41 points (95% CI 5.66–7.16)) and increased the asthma quality of life questionnaire score by 1.08 points (95% CI 0.88–1.28) and forced expiratory volume in 1 s by 0.21 L (95% CI 0.15–0.27) at 12 months. There was a significant reduction in oral corticosteroids use of 51% (risk ratio 0.49, 95% CI 0.42–0.56), with a mean dose reduction of 6.01 mg·day−1 (95% CI −7.55–−4.48) at 12 months of treatment. Similar findings were observed at 3–4, 6 and 24 months. A biomarker-related response to treatment was also noted. Conclusions This comprehensive meta-analysis summarises the significant clinical response to anti-IL-5/5Rα biologics in real-life studies, providing important insights for their use in clinical practice.http://openres.ersjournals.com/content/11/2/00625-2024.full |
| spellingShingle | Christos Kyriakopoulos Efthymia Papadopoulou Dimitrios Potonos Konstantinos Exarchos Evangelos Beris Christina Aggelopoulou Stavros Tryfon Athena Gogali Konstantinos Kostikas Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis ERJ Open Research |
| title | Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis |
| title_full | Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis |
| title_fullStr | Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis |
| title_full_unstemmed | Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis |
| title_short | Effectiveness of anti-IL-5/5Rα biologics in severe asthma in real-world studies: a systematic review and meta-analysis |
| title_sort | effectiveness of anti il 5 5rα biologics in severe asthma in real world studies a systematic review and meta analysis |
| url | http://openres.ersjournals.com/content/11/2/00625-2024.full |
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