Tezepelumab for Patients with Severe Uncontrolled Asthma: A Systematic Review and Meta-Analysis.

Autor: Zoumot Z; Respiratory Institute Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates., Al Busaidi N; Department of Pulmonology, Royal Hospital, Muscat, Sultanate of Oman., Tashkandi W; Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Aljohaney AA; Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia., Isse S; Respiratory Institute Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates., Vidyasagar K; Department of Pharmacy, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, Telangana, 506009, India., Ukwaja KN; Department of Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Jazyk: angličtina
Zdroj: Journal of asthma and allergy [J Asthma Allergy] 2022 Nov 18; Vol. 15, pp. 1665-1679. Date of Electronic Publication: 2022 Nov 18 (Print Publication: 2022).
DOI: 10.2147/JAA.S378062
Abstrakt: Tezepelumab is a human monoclonal antibody that blocks thymic stromal lymphopoietin, an epithelial-cell-derived cytokine implicated in the pathogenesis of asthma. It was approved by the United States Federal Drug Administration (US FDA) as an add-on maintenance treatment for patients with severe uncontrolled asthma in December 2021. We conducted a systematic review and meta-analysis to investigate the safety and efficacy of tezepelumab on forced expiratory volume (FEV 1 ) (L), the rate of asthma exacerbations, health-related quality of life, fractional exhaled nitric oxide (FeNO) (ppb), and blood eosinophil count (cells/mL) in patients with severe, uncontrolled asthma. Mean changes for efficacy and proportions (safety) with their corresponding 95% confidence intervals (CIs) were used to provide pooled estimates. A total of six randomized controlled trials comprising 2667 patients were included, of whom 1610 were treated with tezepelumab and 1057 received placebo. The pooled analysis showed that tezepelumab treatment resulted in an improvement in FEV 1 of 0.15 L (95% CI: 0.12 to 0.17), a reduction in the asthma exacerbation rate per year of 0.60 (95% CI: 0.51 to 0.70), and a reduction in FeNO of -12.41 ppb (95% CI: -14.28 to -10.53) when compared to placebo. Improvements in FEV 1 and FeNO levels were maintained at 24 and 52 weeks. As for safety, patients did not experience a higher incidence of adverse drug reactions with tezepelumab (0.79 (95% CI: 0.55 to 1.12)) as compared to placebo. As for quality of life, different doses of the tezepelumab intervention group depicted non-significant improvement in the QoL, from 0.15 (95% CI: -0.09 to 0.38) for 70 mg, 0.18 (95% CI: -0.10 to 0.46) for 210 mg, 0.08 (95% CI: -0.16 to 0.32) for 280 mg as compared to the placebo. Tezepelumab significantly reduced exacerbation rates and improved FEV 1 with an acceptable safety profile.
Competing Interests: The authors report no conflicts of interest in this work.
(© 2022 Zoumot et al.)
Databáze: MEDLINE
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