The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
Guangzhou University of Chinese Medicine, Guangzhou, China.
Front Immunol. 2023 Apr 11;14:1089710. doi: 10.3389/fimmu.2023.1089710. eCollection 2023.
Anti-type 2 inflammation therapy has been proposed as a treatment strategy for eosinophil-associated chronic airway disorders that could reduce exacerbations and improve lung function. We performed a meta-analysis of randomized controlled trials to assess the effectiveness of type 2 monoclonal antibodies (anti-T2s) for eosinophil-associated chronic airway disorders.
PubMed, Embase, Web of Science, and Cochrane Library were searched from their inception to 21 August 2022. Randomized clinical trials evaluating the effectiveness of anti-T2s versus placebo in the treatment of chronic airway diseases were selected. The outcomes were exacerbation rate and change in pre-bronchodilator forced expiratory volume in 1 s (FEV1) from baseline. The Cochrane Risk of Bias Assessment Tool 1.0 was used to evaluate the risk of bias, and the random-effects or fixed-effect model were used to pool the data.
Thirty-eight articles concerning forty-one randomized clinical trials with 17,115 patients were included. Compared with placebo, anti-T2s therapy yielded a significant reduction in exacerbation rate in COPD and asthma (Rate Ratio (RR)=0.89, 95%CI, 0.83-0.95, I 29.4%; RR= 0.59, 95%CI, 0.52-0.68, I 83.9%, respectively) and improvement in FEV1 in asthma (Standard Mean Difference (SMD)=0.09, 95%CI, 0.08-0.11, I 42.6%). Anti-T2s therapy had no effect on FEV1 improvement in COPD (SMD=0.05, 95%CI, -0.01-0.10, I 69.8%).
Despite inconsistent findings across trials, anti-T2s had a positive overall impact on patients' exacerbation rate in asthma and COPD and FEV1 in asthma. Anti-T2s may be effective in treating chronic airway illnesses related to eosinophils.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022362280.
抗 2 型炎症疗法已被提议作为一种治疗嗜酸性粒细胞相关慢性气道疾病的策略，可减少恶化并改善肺功能。我们对随机对照试验进行了荟萃分析，以评估 2 型单克隆抗体（抗 T2s）治疗嗜酸性粒细胞相关慢性气道疾病的疗效。
从建库到 2022 年 8 月 21 日，检索了 PubMed、Embase、Web of Science 和 Cochrane Library。选择了评估抗 T2s 与安慰剂治疗慢性气道疾病有效性的随机临床试验。主要结局为恶化率和支气管扩张剂前用力呼气量 1 秒（FEV1）从基线的变化。使用 Cochrane 偏倚风险评估工具 1.0 评估偏倚风险，并使用随机效应或固定效应模型汇总数据。
共纳入 38 篇文章，涉及 41 项随机临床试验，共纳入 17115 例患者。与安慰剂相比，抗 T2s 治疗可显著降低 COPD 和哮喘的恶化率（RR=0.89，95%CI，0.83-0.95，I 29.4%；RR=0.59，95%CI，0.52-0.68，I 83.9%）和哮喘的 FEV1 改善（SMD=0.09，95%CI，0.08-0.11，I 42.6%）。抗 T2s 治疗对 COPD 的 FEV1 改善无影响（SMD=0.05，95%CI，-0.01-0.10，I 69.8%）。
尽管试验结果不一致，但抗 T2s 对哮喘和 COPD 患者的恶化率和哮喘患者的 FEV1 总体有积极影响。抗 T2s 可能对治疗与嗜酸性粒细胞相关的慢性气道疾病有效。
https://www.crd.york.ac.uk/PROSPERO/，标识符 CRD42022362280。
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