Meta-analysis of the efficacy and safety of dupilumab on the treatment of bronchial asthma

doi:10.3969/j.issn.1004-583X.2023.10.001

Abstract

Abstract: Objective To systematically evaluate the efficacy and safety of dupilumab on the treatment of bronchial asthma. Methods Randomized controlled trials (RCTs) reporting the treatment of dupilumab for bronchial asthma published from database establishment to February 20 in 2023 were systematically searched in CNKI, Wanfang Database, VIP, Chinese Biomedical Literature Database (CBM), Cochrane Library, PubMed, Embase and Web of Science. Meta-analysis was performed by RevMan5.4 software. Results A total of 11 RCTs involving 3759 bronchial asthma patients were enrolled. Meta-analysis results showed that the number of patients with acute exacerbation of asthma (RR=0.48, 95%CI: 0.40, 0.57, P<0.01) and the Asthma Control Questionnaire (ACQ) score (MD=-0.32, 95%CI: -0.43, -0.21, P<0.01) were significantly lower in the experimental group than those of control group. The forced expiratory volume in 1s (FEV₁, MD=0.51, 95% CI: 0.31,0.71, P<0.01) and the Asthma Quality of Life Questionnaire (AQLQ) score (MD=0.32, 95%CI: 0.20, 0.44, P<0.01) were significantly higher than those of the control group. There were no significant differences in the number of bronchial asthma patients with blood eosinophil count <300/μl (RR=1.10, 95%CI: 0.93, 1.31, P=0.26), incidence of adverse events (RR=1.03, 95%CI: 0.98,1.08, P=0.22) and incidence of serious adverse events (RR=1.21, 95%CI: 0.86, 1.71, P=0.28) between groups (P>0.05). Conclusion Dupilumab can decrease the number of asthma exacerbations, improve pulmonary function and quality of life with a high safety.

Key words: dupilumab, bronchial asthma, Meta-analysis, randomized controlled trial

CLC Number:

R562.25

Ruan Junwen, Zhou Jianrong, Liu Weiyou, Yuan Xiaoliang, Yan Hao. Meta-analysis of the efficacy and safety of dupilumab on the treatment of bronchial asthma[J]. Clinical Focus, 2023, 38(10): 869-877.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2023.10.001

https://huicui.hebmu.edu.cn/EN/Y2023/V38/I10/869

Figures/Tables 14

References 26

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纳入研究	病例数	平均年龄(岁)		干预措施		疗程	结局指标
纳入研究	T/C	T	C	T	C	疗程	结局指标
Bacharier 2021^[11]	273/135	8.9±1.6	9.0±1.6	达必妥100 mg q2w(W≤30kg), 200 mg q2w(W>30kg)	安慰剂q2w	52w	①②③④⑥⑦
Busse(a) 2018^[12]	634/317	≥12		达必妥200 mg q2w	安慰剂q2w	52w	②
Busse(b) 2018^[12]	634/317	≥12		达必妥300 mg q2w	安慰剂q2w	52w	②
Domingo 2022^[13]	103/107	52.9±12.6	50.3±12.6	达必妥300 mg q2w	安慰剂q2w	24w	①②④⑥
Rabe 2018^[9]	103/107	51.9±12.5	50.7±12.8	达必妥300 mg q2w	安慰剂q2w	24w	①②③⑥⑦
Wechsler 2021^[14]	75/74	51.3±12.7	47.0±11.4	达必妥300 mg q2w	安慰剂q2w	12w	①②③④⑤⑥⑦
Wenzel(a) 2016^[15]	150/158	48.6±13.0		达必妥200 mg q2w	安慰剂q2w	24w	①②④⑤⑥⑦
Wenzel(b) 2016^[15]	154/158	48.6±13.0		达必妥200 mg q4w	安慰剂q4w	24w	①②④⑤⑥⑦
Wenzel(c) 2016^[15]	157/158	48.6±13.0		达必妥300 mg q2w	安慰剂q2w	24w	①②④⑤⑥⑦
Wenzel(d) 2016^[15]	157/158	48.6±13.0		达必妥300 mg q4w	安慰剂q4w	24w	①②④⑤⑥⑦
Wenzel 2013^[16]	52/52	37.8±13.2	41.6±13.1	达必妥300 mg qw	安慰剂qw	12w	①④⑥⑦

纳入研究	病例数	平均年龄(岁)		干预措施		疗程	结局指标
纳入研究	T/C	T	C	T	C	疗程	结局指标
Bacharier 2021^[11]	273/135	8.9±1.6	9.0±1.6	达必妥100 mg q2w(W≤30kg), 200 mg q2w(W>30kg)	安慰剂q2w	52w	①②③④⑥⑦
Busse(a) 2018^[12]	634/317	≥12		达必妥200 mg q2w	安慰剂q2w	52w	②
Busse(b) 2018^[12]	634/317	≥12		达必妥300 mg q2w	安慰剂q2w	52w	②
Domingo 2022^[13]	103/107	52.9±12.6	50.3±12.6	达必妥300 mg q2w	安慰剂q2w	24w	①②④⑥
Rabe 2018^[9]	103/107	51.9±12.5	50.7±12.8	达必妥300 mg q2w	安慰剂q2w	24w	①②③⑥⑦
Wechsler 2021^[14]	75/74	51.3±12.7	47.0±11.4	达必妥300 mg q2w	安慰剂q2w	12w	①②③④⑤⑥⑦
Wenzel(a) 2016^[15]	150/158	48.6±13.0		达必妥200 mg q2w	安慰剂q2w	24w	①②④⑤⑥⑦
Wenzel(b) 2016^[15]	154/158	48.6±13.0		达必妥200 mg q4w	安慰剂q4w	24w	①②④⑤⑥⑦
Wenzel(c) 2016^[15]	157/158	48.6±13.0		达必妥300 mg q2w	安慰剂q2w	24w	①②④⑤⑥⑦
Wenzel(d) 2016^[15]	157/158	48.6±13.0		达必妥300 mg q4w	安慰剂q4w	24w	①②④⑤⑥⑦
Wenzel 2013^[16]	52/52	37.8±13.2	41.6±13.1	达必妥300 mg qw	安慰剂qw	12w	①④⑥⑦