Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial

Pavord, Ian D.; Korn, Stephanie; Howarth, Peter H.; Bleecker, Eugene R.; Buhl, Roland; Keene, Oliver N.; Ortega, Héctor; Chanez, Pascal

doi:10.1016/s0140-6736(12)60988-x

Cited by 1,893 publications

(1,737 citation statements)

References 26 publications

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“…In total, five randomised trials reported in four papers [22–24,29] comprising a total of 2197 patients were included in the meta-analysis. The rate ratio for the number of annual exacerbations showed a favourable effect in the anti-IL-5 group compared to placebo (rate ratio 0.47 [95% CI 0.41; 0.54), which can be translated into an absolute risk reduction of 53% (95% CI 46; 59) (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies were included comprising 1244 patients [22–24]. The rate ratio of annual exacerbations was 0.47 [95% CI 0.40; 0.56] in favour of the mepolizumab group compared to placebo.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were included comprising 884 patients [22,24,25]. The relative improvement was 1.58 (95% CI 1.33; 1.87) on the percentage of patients experiencing 0 exacerbations in favour of the anti-IL-5 group.…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies of 3165 patients were included; four mepolizumab studies (three using Asthma Control Questionnaire [ACQ]5 [22,23,25], and one ACQ6 [24]), and reslizumab studies (all used ACQ7 [26–29]). We pooled the results from the different ACQ versions in the meta-analysis and found a change of −0.29 points (95% CI −036; −0.23) in the anti-IL-5 group compared to placebo, which was below the minimal clinically important effect of 0.5 points (Figure 8).…”

Section: Resultsmentioning

confidence: 99%

“…We included four studies using the Asthma Quality of Life Questionnaire (AQLQ): one mepolizumab study [24] and three reslizumab studies [26,29]. Further three studies were included, which used SGRQ, in which the MCID is 4 points [22,23,25], which gave a total of 2562 included patients.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab anti-IL-5 treatments of severe asthma – a systematic review and meta-analysis

Henriksen

Bødtger

Sidenius³

et al. 2018

European Clinical Respiratory Journal

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Background: New, complex, and expensive therapies targeting Interleukin-5 (IL-5) to treat severe eosinophilic asthma are emerging.Objective: To assess efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab for treating severe eosinophilic asthma.Design: A systematic review and meta-analysis on randomized, placebo-controlled, clinical trials elucidating two critical (exacerbation rate and oral corticosteroid (OCS) use) and six important clinical outcomes on the efficacy and safety of mepolizumab and reslizumab.Results: Five studies (N = 2197) contributed with data for exacerbation rate, showing a reduction of 53% (95% CI 46; 59) in favour of anti-IL-5, corresponding to –0.94 annual exacerbations (95% CI –1.08;–0.82), thus exceeding the predefined minimal clinical important difference (MCID) of 25% reduction of the estimated ≥2 annual exacerbations. Quality of evidence was considered moderate, with low heterogeneity in study findings (I2 = 0%). One study (N = 135) contributed with data on percentage of patients experiencing ≥50% reduction inoral corticosteroid treatment, showing an effect of 20% (95% CI 2.3;47) in favour of anti-IL-5 treatment (mepolizumab), thus exceeding the predefined MCID of 10%. Quality of evidence was considered low.Compared to placebo, anti-IL-5 showed significant improvements in lung function, asthma control, and asthma-related quality of life, but below the MCIDs. No differences were observed for serious adverse events and number of patients, who dropped out. No studies evaluating sickleave or head-to-head comparisons were identified. By indirect comparison, we found no significant difference between mepolizumab and reslizumab in any ofthe predefined clinical outcomes. OCS treatment reduction could not be compared due to lack of reslizumab studies investigating this outcome.Conclusions: Mepolizumab and reslizumab provide significant and clinically relevant improvements in exacerbation rate and OCS reduction. Indirect, inter-study comparisons revealed no differences between the anti-IL-5 drugs in efficacy or safety measures.

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Section: Resultsmentioning

confidence: 99%

“…Three studies were included comprising 1244 patients [22–24]. The rate ratio of annual exacerbations was 0.47 [95% CI 0.40; 0.56] in favour of the mepolizumab group compared to placebo.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab anti-IL-5 treatments of severe asthma – a systematic review and meta-analysis

Henriksen

Bødtger

Sidenius³

et al. 2018

European Clinical Respiratory Journal

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Omalizumab for asthma in adults and children

Normansell

Walker

Milan

et al. 2014

Cochrane Database of Systematic Reviews

447

411

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Mepolizumab versus placebo for asthma

Powell

Milan

Dwan

et al. 2013

Cochrane Database of Systematic Reviews

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Background Mepolizumab is a human monoclonal antibody against interleukin-5 (IL-5), the main cytokine involved in the activation of eosinophils, which in turn causes airway inflammation. Recent studies have suggested these agents may have a role in reducing exacerbations and improving health-related quality of life (HRQoL). There are no recommendations for the use of mepolizumab in adults or children in the recent update of the BTS/SIGN guidelines (BTS/SIGN 2014).

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Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial

Cited by 1,893 publications

References 26 publications

Efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab anti-IL-5 treatments of severe asthma – a systematic review and meta-analysis

Efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab anti-IL-5 treatments of severe asthma – a systematic review and meta-analysis

Omalizumab for asthma in adults and children

Mepolizumab versus placebo for asthma

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