Effects of Dupilumab for Asthma-chronic Obstructive Pulmonary  Disease Overlap

Kodaka, Norio; Nakano, Chihiro; Oshio, Takeshi; Hirouchi, Takatomo; Yamada, Yoshitake; Matsuse, Hiroto

doi:10.18502/ijaai.v22i2.12683

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“…In this study, Dupilumab showed better developmental promise as far as lung function improvement is concerned (40). Dupilumab is a fully human monoclonal antibody that binds IL-4Rα and inhibits signaling of both IL-4 and IL-13 (33), which plays a central role in the inflammatory processes.…”

Section: Discussionmentioning

confidence: 95%

Network meta-analysis of the efficacy and safety of monoclonal antibodies and traditional conventional dichotomous agents for chronic obstructive pulmonary disease

Xiong,

Hu,

Tang

et al. 2024

Front. Med.

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IntroductionMonoclonal antibodies (mAbs) against cytokines and chemokines or their receptors promise to be a potential therapeutic option to address chronic obstructive pulmonary disease (COPD). We aim to provide a comprehensive literature review of the improvement in FEV1 and safety when comparing mAbs with conventional dichotomous agents.MethodsWe systematically searched 3 electronic databases (PubMed, EMBASE, and CENTRAL) up to August 1, 2023 to collect eligible randomized controlled trials (RCTs). A frequentist network meta-analysis using a random-effects model was deployed to calculate mean differences (MD) for FEV1, relative risk (RR) of treatment-emergent adverse events (TEAEs), and estimate the surface under cumulative rankings (SUCRA). A higher SUCRA indicates a better outcome.ResultsThis study included 23 RCTs involving a total of 20,853 patients. Overall, except for Dupilumab, mAbs did not significantly improve FEV1 compared to traditional conventional dichotomous agents. Among all the interventions included, Aclidinium bromide/Formoterol (AB/FF) (SUCRA 97.7%) ranked highest, followed by Umeclidinium/vilanterol (UMEC/VI) (SUCRA 93.5%), and Glycopyrrolate Formoterol Fumarate (GFF) (SUCRA 84.7%). Dupilumab (SUCRA 66.9%) ranked the fourth among all interventions but ranked the first among all the mAbs. Importantly, all mAbs demonstrated a good safety profile compared with placebo.ConclusionConsidering the improvement in FEV1 and its safety, the development of mAbs for COPD still holds significant clinical potential.Systematic review registrationPROSPERO, CRD42023452714.

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Section: Discussionmentioning

confidence: 95%