Reslizumab Compared with Benralizumab in Patients with Eosinophilic Asthma: A Systematic Literature Review and Network Meta-Analysis

Indirect treatment comparisons and biologics

“…However, 2 recent publications have constructed indirect comparisons based on separate placebo-controlled clinical trials. 4,5 Interestingly, the results are not completely congruent.…”

“…For example, both NMAs include trials that differ by duration of intervention therapy, ranging from 15 to 56 weeks. 4,5 In addition, although all of the trials included in these NMAs used placebos, that does not necessarily make them equivalent comparators. Because asthma outcomes are affected by background controller medications (eg, inhaled corticosteroids/long-acting b-agonists), we cannot be confident that the placebo arms of the component trials offer comparable results.…”

“…With all of the differences in the trials available for inclusion, it is not surprising that these 2 NMAs comparing mAbs report different results. 4,5 As we try to learn about and compare these new biologics, it is critical to understand the limitations of the NMA. Most important, they must include some head-to-head trials making direct comparisons to rigorously and objectively evaluate the critical assumption of consistency.…”

Cost-effectiveness and comparative effectiveness of biologic therapy for asthma

“…13 Reslizumab was found to significantly improve ACQ and AQLQ scores compared with benralizumab administered every 4 weeks, but the magnitude of these changes did not meet the minimal important difference. 13 Although not statistically significant, reslizumab had a higher posterior probability of superiority over benralizumab administered every 8 weeks for ACQ scores, AQLQ scores, FEV 1 , and clinical asthma exacerbations. 13 With regard to the change in FEV 1 , the authors note heterogeneity existed among the studies, with a greater improvement seen in the placebo groups in the benralizumab studies vs the reslizumab studies.…”

“…12 Unlike the aforementioned study, a separate network metaanalysis controlled for the heterogeneity between benralizumab and reslizumab studies by only selecting a benralizumab subgroup with a blood eosinophil count of 300/mL and a reslizumab subgroup with GINA step 4/5 or 2 previous exacerbations and an eosinophil count of 400/mL. 13 Reslizumab was found to significantly improve ACQ and AQLQ scores compared with benralizumab administered every 4 weeks, but the magnitude of these changes did not meet the minimal important difference. 13 Although not statistically significant, reslizumab had a higher posterior probability of superiority over benralizumab administered every 8 weeks for ACQ scores, AQLQ scores, FEV 1 , and clinical asthma exacerbations.…”