Background

Anti-interleukin-5 (IL-5) therapy has been proposed as a novel treatment option for patients with chronic obstructive pulmonary disease (COPD). However, its efficacy for preventing COPD exacerbation remains unclear.

Methods

A literature review was conducted to August 26th 2019. Only randomized controlled trials (RCTs) that investigated the clinical efficacy and adverse effects of anti-IL-5 therapy were included in the meta-analysis. The primary outcome was the risk of COPD exacerbation.

Results

A total of 3 articles containing 5 RCTs were included in the study. Overall, 2837 and 1442 patients received anti-IL-5 therapy (mepolizumab, n = 865; benralizumab, n = 1972) and placebo, respectively. In the pooled analysis, anti-IL-5 therapy was associated with a lower risk of COPD exacerbation compared with the placebo (rate ratio, 0.92; 95% CI, 0.86–0.97, I² = 0%). In addition, no significant differences in the changes in SGRQ scores and FEV₁ from baseline were found between the anti-IL-5 therapy and placebo (SGRQ, mean difference, −0.86, 95% CI, −1.92 – 0.19, I² = 0%; FEV₁, mean difference, 0.01, 95% CI, −0.01 – 0.03, I² = 0%). Anti-IL-5 therapy had a similar risk of any adverse event (risk ratio, 1.02; 95% CI, 0.99–1.05), an event leading to treatment discontinuation (risk ratio, 1.04; 95% CI, 0.72–1.48) and any serious adverse events (risk ratio, 0.93; 95% CI, 0.85–1.01) when compared with the placebo.

Conclusion

Anti-IL-5 therapy was associated with a lower rate of COPD exacerbation compared with placebo. In addition, anti-IL-5 therapy was well tolerated for COPD patients.

中文翻译：

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抗白细胞介素5治疗慢性阻塞性肺病患者的疗效和安全性：随机对照试验的荟萃分析

背景

抗白细胞介素 5 (IL-5) 疗法已被提议作为慢性阻塞性肺病 (COPD) 患者的新治疗选择。然而，其预防COPD恶化的功效仍不清楚。

方法

文献回顾进行至 2019 年 8 月 26 日。荟萃分析仅包括调查抗 IL-5 治疗的临床疗效和不良反应的随机对照试验 (RCT)。主要结果是 COPD 恶化的风险。

结果

该研究共纳入 3 篇包含 5 项 RCT 的文章。总体而言，2837 名和 1442 名患者分别接受了抗 IL-5 治疗（美泊利珠单抗，n = 865；贝那利珠单抗，n = 1972）和安慰剂。在汇总分析中，与安慰剂相比，抗 IL-5 治疗与较低的 COPD 恶化风险相关（比率，0.92；95% CI，0.86-0.97，I ²  = 0%）。此外，在抗 IL-5 治疗和安慰剂之间，SGRQ 评分和 FEV ₁相对于基线的变化没有显着差异（SGRQ，平均差，-0.86，95% CI，-1.92 – 0.19，I ²  = 0%；FEV ₁，平均差，0.01，95% CI，-0.01 – 0.03，I ² = 0%）。抗 IL-5 治疗具有相似的任何不良事件风险（风险比，1.02；95% CI，0.99-1.05），导致治疗中断的事件（风险比，1.04；95% CI，0.72-1.48）和与安慰剂相比，任何严重的不良事件（风险比，0.93；95% CI，0.85-1.01）。

结论

与安慰剂相比，抗 IL-5 治疗与较低的 COPD 恶化率相关。此外，抗 IL-5 治疗对 COPD 患者具有良好的耐受性。