Efficacy and safety of treatment with biologicals (benralizumab, dupilumab and omalizumab) for severe allergic asthma: A systematic review for the EAACI Guidelines ‐ recommendations on the use of biologicals in severe asthma
-
- Ioana Agache
- Faculty of Medicine Transylvania University Brasov Romania
-
- Claudio Rocha
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Jessica Beltran
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Yang Song
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Margarita Posso
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Ivan Solà
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Pablo Alonso‐Coello
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Cezmi Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
-
- Mubeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
-
- Giorgio W. Canonica
- Personalized Medicine, Asthma and Allergy Humanitas Clinical and Research Center IRCCS Rozzano Italy
-
- Thomas Casale
- Division of Allergy and Immunology University of South Florida Morsani College of Medicine Tampa FL USA
-
- Tomas Chivato
- School of Medicine University CEU San Pablo Madrid Spain
-
- Jonathan Corren
- David Geffen School of Medicine at UCLA Los Angeles CA USA
-
- Stefano Del Giacco
- Department of Medical Sciences and Public Health University of Cagliari Italy Monserrato
-
- Thomas Eiwegger
- Translational Medicine Program, Research Institute Hospital for Sick Children Toronto ON Canada
-
- Davide Firinu
- Department of Medical Sciences and Public Health University of Cagliari Italy Monserrato
-
- James E. Gern
- Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison WI USA
-
- Eckard Hamelmann
- Klinik für Kinder‐ und Jugendmedizin Kinderzentrum Bethel Bielefeld Germany
-
- Nicola Hanania
- Section of Pulmonary, Critical Care and Sleep Medicine Baylor College of Medicine Houston Texas USA
-
- Mika Mäkelä
- Skin and Allergy Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland
-
- Irene Hernández Martín
- Department of Allergy Hospital Universitario La Paz Madrid Spain
-
- Parameswaran Nair
- Division of Respirology Department of Medicine McMaster University Hamilton ON Canada
-
- Liam O'Mahony
- Departments of Medicine and Microbiology APC Microbiome Ireland University College Cork Cork Ireland
-
- Nikolaos G. Papadopoulos
- Division of Infection Immunity & Respiratory Medicine University of Manchester Manchester UK
-
- Alberto Papi
- Research Center on Asthma and COPD Department of Medical Sciences University of Ferrara Ferrara Italy
-
- Hae‐Sim Park
- Department of Allergy and Clinical Immunology Ajou University Suwon South Korea
-
- Luis Pérez de Llano
- Department of Respiratory Medicine Hospital Lucus Augusti Lugo Spain
-
- Santiago Quirce
- Department of Allergy La Paz University Hospital IdiPAZ CIBER of Respiratory Diseases (CIBERES) Universidad Autónoma de Madrid Madrid Spain
-
- Joaquin Sastre
- Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain
-
- Mohamed Shamji
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Inflammation Repair, Development National Heart and Lung Institute London UK
-
- Jurgen Schwarze
- Centre for Inflammation Research Child Life and Health The University of Edinburgh Edinburgh UK
-
- Carlos Canelo‐Aybar
- Iberoamerican Cochrane Centre Department of Clinical Epidemiology and Public Health Biomedical Research Institute Sant Pau (IIB Sant Pau) Barcelona Spain
-
- Oscar Palomares
- Department of Biochemistry and Molecular Biology Chemistry School Complutense University of Madrid Madrid Spain
-
- Marek Jutel
- Department of Clinical Immunology Wroclaw Medical University Wroclaw Poland
Abstract
<jats:title>Abstract</jats:title><jats:p>Allergic asthma is a frequent asthma phenotype. Both IgE and type 2 cytokines are increased, with some degree of overlap with other phenotypes. Systematic reviews assessed the efficacy and safety of benralizumab, dupilumab and omalizumab (alphabetical order) vs standard of care for patients with uncontrolled severe allergic asthma. PubMed, Embase and Cochrane Library were searched to identify RCTs and health economic evaluations, published in English. Critical and important asthma‐related outcomes were evaluated. The risk of bias and the certainty of the evidence were assessed using GRADE. All three biologicals reduced with high certainty the annualized asthma exacerbation rate: benralizumab incidence rate ratios (IRR) 0.63 (95% CI 0.50 − 0.81); dupilumab IRR 0.58 (95%CI 0.47 − 0.73); and omalizumab IRR 0.56 (95%CI 0.42 − 0.73). Benralizumab and dupilumab improved asthma control with high certainty and omalizumab with moderate certainty; however, none reached the minimal important difference (MID). Both benralizumab and omalizumab improved QoL with high certainty, but only omalizumab reached the MID. Omalizumab enabled ICS dose reduction with high certainty. Benralizumab and omalizumab showed an increase in drug‐related adverse events (AEs) with low to moderate certainty. All three biologicals had moderate certainty for an ICER/QALY value above the willingness to pay threshold. There was high certainty that in children 6‐12 years old omalizumab decreased the annualized exacerbation rate [IRR 0.57 (95%CI 0.45‐0.72)], improved QoL [relative risk 1.43 (95%CI 1.12 −1.83)], reduced ICS [mean difference (MD) −0.45 (95% CI −0.58 to −0.32)] and rescue medication use [ MD −0.41 (95%CI −0.66 to −0.15)].</jats:p>
Journal
-
- Allergy
-
Allergy 75 (5), 1043-1057, 2020-05
Wiley
- Tweet
Details 詳細情報について
-
- CRID
- 1360576122635444224
-
- ISSN
- 13989995
- 01054538
-
- Data Source
-
- Crossref