Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Respiratory Medicine, First Affiliated Hospital of Henan College of Traditional Chinese Medicine, Zhengzhou, 450000, China.
Clin Rev Allergy Immunol. 2018 Apr;54(2):318-330. doi: 10.1007/s12016-016-8588-x.
Recently, more and more clinical trials have been performed to evaluate the effects of anti-interleukin (IL)-5 antibodies in eosinophilic asthma. However, a confirm conclusion has not been well established. We therefore sought to conduct a meta-analysis to assess the overall efficacy and safety of anti-interleukin 5 treatments in eosinophilic asthma. RCTs of anti-interleukin 5 treatments in eosinophilic asthma published up to June 2016 in PubMed, Embase, Cochrane library databases, and CBM, which reported pulmonary functions, quality-of-life scores, asthmatic exacerbations, and adverse events were included. Fixed-effect models were used to calculate mean difference, relative risks (RR), and 95 % CIs. Twelve studies involving 3340 patients were identified. Pooled analysis revealed significant improvements in FEV (nine trials, 1935 subjects; MD = 0.12; 95 % CI, 0.08-0.16), and Asthma Quality-of-Life Questionnaire scores (five trials, 1334 subjects; MD = 0.23; 95 % CI, 0.13-0.34). Anti-interleukin 5 treatment was also associated with significantly decreased exacerbation risk than placebo (six trials, 875 subjects; RR = 0.52; 95 % CI, 0.46 to 0.59) and a lower incidence of adverse events (eight trials, 1754 subjects; RR = 0.93; 95 % CI, 0.89 to 0.97). Anti-interleukin 5 treatment is well tolerated and could significantly improve FEV, quality of life, and reduced exacerbations risk in patients with eosinophilic asthma. Further trials are necessary to assess the baseline blood eosinophil count to identify the optimal patients of eosinophilic asthma that could benefit from anti-interleukin 5 therapy.
最近,越来越多的临床试验评估了抗白细胞介素(IL)-5 抗体在嗜酸性粒细胞性哮喘中的作用。然而,尚未得出明确的结论。因此,我们旨在进行荟萃分析,以评估抗白细胞介素 5 治疗在嗜酸性粒细胞性哮喘中的总体疗效和安全性。我们检索了 PubMed、Embase、Cochrane 图书馆数据库和 CBM 中截至 2016 年 6 月发表的关于抗白细胞介素 5 治疗嗜酸性粒细胞性哮喘的 RCT 研究,纳入报告肺功能、生活质量评分、哮喘加重和不良事件的研究。采用固定效应模型计算均数差值、相对危险度(RR)及其 95%可信区间(95% CI)。共纳入 12 项研究,共计 3340 例患者。汇总分析显示,FEV(9 项研究,1935 例患者;MD=0.12;95%CI,0.08-0.16)和哮喘生命质量问卷评分(5 项研究,1334 例患者;MD=0.23;95%CI,0.13-0.34)均显著改善。与安慰剂相比,抗白细胞介素 5 治疗还显著降低了哮喘加重风险(6 项研究,875 例患者;RR=0.52;95%CI,0.46-0.59)和不良事件发生率(8 项研究,1754 例患者;RR=0.93;95%CI,0.89-0.97)。抗白细胞介素 5 治疗具有良好的耐受性,可显著改善嗜酸性粒细胞性哮喘患者的 FEV、生活质量,并降低哮喘加重风险。进一步的研究需要评估基线血嗜酸性粒细胞计数,以确定可能从抗白细胞介素 5 治疗中获益的嗜酸性粒细胞性哮喘的最佳患者。