Zahi Nachef1, Amita Krishnan2, Terry Mashtare3, Tingting Zhuang3, M Jeffery Mador1. 1. a Department of Internal Medicine-Division of Pulmonary and Critical Care Medicine , The State University of New York at Buffalo-School of Medicine , Buffalo , NY , USA. 2. b Department of Internal Medicine , The State University of New York at Buffalo-School of Medicine , Buffalo , NY , USA. 3. c Department of Biostatistics , The State University of New York at Buffalo , Buffalo , NY , USA.
Abstract
OBJECTIVE: The purpose of this study is to examine the comparative efficacy of Omalizumab (OMA) and Mepolizumab (Mepo) in the treatment of severe asthma by performing a network meta-analysis. METHOD: Data Sources: A systematic review of the literature was performed through four databases from their inception to February 2016. STUDY SELECTIONS: Randomized control trials and cohort studies were considered if they addressed the individual efficacy of OMA and Mepo in the treatment of asthma that was not well controlled on inhaled corticosteroids (ICSs) with or without other agents. RESULTS: OMA was significantly better than Mepo in improving the Asthma Quality of Life Questionnaire with a mean difference of 0.38 and a confidence interval of (0.21-0.55), p < 0.0001, without reaching the minimal clinically important difference of 0.5. No significant difference was seen in Asthma Control Questionnaire, forced expiratory volume in second 1 (FEV1), and Peak Expiratory Flow Rate (PEFR) improvement from baseline. Both medications were successful in reducing the calculated annualized rates of asthma exacerbations (AEs) vs placebo by approximately 50%. The heterogeneity score for the different comparisons were elevated except for the PEFR. CONCLUSION: When compared indirectly via a network meta-analysis, the efficacy of OMA and Mepo was similar in the treatment of asthma that was not well controlled on at least high-dose ICS. The high heterogeneity observed and the different selection criteria for the use of the two drugs do not permit us to make any definitive recommendations for the preferential use of OMA vs Mepo in the patient populations studied. However, the current data do not suggest any major differences in efficacy.
OBJECTIVE: The purpose of this study is to examine the comparative efficacy of Omalizumab (OMA) and Mepolizumab (Mepo) in the treatment of severe asthma by performing a network meta-analysis. METHOD: Data Sources: A systematic review of the literature was performed through four databases from their inception to February 2016. STUDY SELECTIONS: Randomized control trials and cohort studies were considered if they addressed the individual efficacy of OMA and Mepo in the treatment of asthma that was not well controlled on inhaled corticosteroids (ICSs) with or without other agents. RESULTS:OMA was significantly better than Mepo in improving the Asthma Quality of Life Questionnaire with a mean difference of 0.38 and a confidence interval of (0.21-0.55), p < 0.0001, without reaching the minimal clinically important difference of 0.5. No significant difference was seen in Asthma Control Questionnaire, forced expiratory volume in second 1 (FEV1), and Peak Expiratory Flow Rate (PEFR) improvement from baseline. Both medications were successful in reducing the calculated annualized rates of asthma exacerbations (AEs) vs placebo by approximately 50%. The heterogeneity score for the different comparisons were elevated except for the PEFR. CONCLUSION: When compared indirectly via a network meta-analysis, the efficacy of OMA and Mepo was similar in the treatment of asthma that was not well controlled on at least high-dose ICS. The high heterogeneity observed and the different selection criteria for the use of the two drugs do not permit us to make any definitive recommendations for the preferential use of OMA vs Mepo in the patient populations studied. However, the current data do not suggest any major differences in efficacy.
Authors: Andras Bikov; Ipek Kivilcim Oğuzülgen; Ilaria Baiardini; Marco Contoli; Alexander Emelyanov; Omar Fassio; Juan Carlos Ivancevich; Igor Kaidashev; Krzysztof Kowal; Marina Labor; Lies Lahousse; Stefan Mihaicuta; Silviya Novakova; Alicia Padilla Galo; Alexander Simidchiev; Angelica Tiotiu; Ignacio J Ansotegui; Jonathan A Bernstein; Louis Philippe Boulet; Giorgio Walter Canonica; Lawrence Dubuske; Nelson Rosario; Pierachille Santus; Fulvio Braido Journal: World Allergy Organ J Date: 2020-07-31 Impact factor: 4.084
Authors: Jean-Pierre Llanos; Christopher F Bell; Elizabeth Packnett; Ellen Thiel; Debra E Irwin; Beth Hahn; Hector Ortega Journal: J Asthma Allergy Date: 2019-01-25
Authors: Giorgio Walter Canonica; Giorgio Lorenzo Colombo; Paola Rogliani; Pierachille Santus; Claudia Pitotti; Sergio Di Matteo; Chiara Martinotti; Giacomo Matteo Bruno Journal: Risk Manag Healthc Policy Date: 2020-01-22