Department of Internal Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Department of Medicine, Federal University of Pará, Belém, PA, Brazil.
Curr Allergy Asthma Rep. 2023 Jun;23(6):287-298. doi: 10.1007/s11882-023-01085-y. Epub 2023 May 16.
To assess the effects of tezepelumab on quality of life (QoL) in patients with moderate-to-severe, uncontrolled asthma.
Tezepelumab improves pulmonary function tests (PFTs) and reduces the annualized asthma exacerbation rate (AAER) in patients with moderate-to-severe, uncontrolled asthma. We searched MEDLINE, Embase, and Cochrane Library from inception to September 2022. We included randomized controlled trials comparing tezepelumab versus placebo in patients aged ≥ 12 years with asthma on medium- or high-dose inhaled corticosteroids with ≥ 1 additional controller medication for ≥ 6 months and who had ≥ 1 asthma exacerbation in the 12 months before enrollment. We estimated effects measures with a random-effects model. Of 239 records identified, three studies were included, with a total of 1,484 patients. Tezepelumab significantly decreased biomarkers of T helper 2-driven inflammation, including blood eosinophil count (MD -135.8 [95% CI -164.37, -107.23]) and fractional exhaled nitric oxide (MD -9.64 [95% CI -13.75, -5.53]); improved PFTs, including pre-bronchodilator forced expiratory volume in 1 s (MD 0.18 [95% CI 0.08-0.27]); reduced the AAER (MD 0.47 [95% CI 0.39-0.56]); improved asthma-specific health-related QoL in the Asthma Control Questionnaire-6 (MD -0.33 [95% CI -0.34, -0.32]), Asthma Quality of Life Questionnaire for 12 Years and Older (MD 0.34 [95% CI 0.33, -0.35]), Asthma Symptom Diary (MD -0.11 [95% CI -0.18, -0.04]), and European Quality of Life 5 Dimensions 5 Levels Questionnaire (SMD 3.29 [95% CI 2.03, 4.55]) scores, although not clinically important; and did not change key safety outcomes, including any adverse event (OR 0.78 [95% CI 0.56-1.09]).
评估特泽佩鲁单抗对中重度、未控制的哮喘患者生活质量(QoL)的影响。
特泽佩鲁单抗改善了中重度、未控制的哮喘患者的肺功能测试(PFTs),降低了年化哮喘加重率(AAER)。我们从开始到 2022 年 9 月在 MEDLINE、Embase 和 Cochrane 图书馆进行了搜索。我们纳入了比较特泽佩鲁单抗与安慰剂的随机对照试验,纳入患者为年龄≥12 岁、接受中高剂量吸入皮质类固醇治疗且≥1 种附加控制器药物治疗≥6 个月、且在入组前 12 个月内≥1 次哮喘加重的哮喘患者。我们使用随机效应模型估计效应测量值。在 239 条记录中,有 3 项研究入选,共 1484 名患者。特泽佩鲁单抗显著降低了 T 辅助 2 驱动炎症的生物标志物,包括血嗜酸性粒细胞计数(MD -135.8[95%CI-164.37,-107.23])和呼出气一氧化氮分数(MD -9.64[95%CI-13.75,-5.53]);改善了 PFTs,包括支气管扩张剂前用力呼气量 1 秒(MD 0.18[95%CI0.08-0.27]);降低了 AAER(MD 0.47[95%CI0.39-0.56]);改善了哮喘控制问卷-6(MD -0.33[95%CI-0.34,-0.32])、12 岁及以上哮喘生活质量问卷(MD 0.34[95%CI-0.33,-0.35])、哮喘症状日记(MD -0.11[95%CI-0.18,-0.04])和欧洲生活质量 5 维度 5 级问卷(SMD 3.29[95%CI2.03,4.55])评分,尽管没有临床意义;并且没有改变关键安全性结局,包括任何不良事件(OR 0.78[95%CI0.56-1.09])。