Table 3.
Post-hoc and meta-analyses of mepolizumab in severe eosinophilic asthma.
| Author (ref.) | Study design | Study population | Mepolizumab dose | Primary outcomes | Secondary outcomes |
|---|---|---|---|---|---|
| Ortega and colleagues61 | Post-hoc analysis of data from two randomized, DBPC studies (DREAM and MENSA studies) | 1192 severe eosinophilic asthma patients | DREAM: 75 mg, 250 mg, or 750 mg IV; MENSA: 75 mg IV or 100 mg SC | - Annualized rate of exacerbations in patients stratified by blood eosinophil counts and blood eosinophil ranges | - FEV1
- ACQ-5 score - SGRQ score. |
| Magnan and colleagues65 | Post-hoc analysis of data from two randomized, DBPC studies (MENSA and SIRIUS) | 711 severe eosinophilic asthma patients (prior omalizumab use = 120; no prior omalizumab use = 591 | 75 mg IV and 100 mg SC | - Rate of exacerbations (MENSA) - Percentage reduction in OCS dose (SIRIUS) |
- FEV1
- PEF - ACQ-5 score - SGRQ score - Blood eosinophil count - Total IgE - AEs |
| Shimoda and colleagues62 | Post-hoc analysis of the Japanese population from the DBPC, double-dummy, phase III MENSA trial | 50 severe eosinophilic asthma patients | 75 mg IV or 100 mg SC | - Annualized rate of exacerbations | - Annualized rate of exacerbations requiring emergency department visit/hospitalization - Pre-bronchodilator FEV1 - Morning PEF - SGRQ score - ACQ-5 score - Eosinophil count - AEs. |
| Yancey and colleagues63 | Meta-analysis | 1388 severe eosinophilic asthma patients | 75 mg, 250 mg, or 750 mg IV and 100 mg SC | - Annual rate of exacerbations requiring hospitalization - Annual rate of exacerbations requiring a hospitalization or an emergency room visit |
NA |
| Cabon and colleagues64 | Meta-analysis (comparison between mepolizumab, reslizumab and benralizumab) | 3421 severe eosinophil asthma patients | 75 mg, 250 mg, or 750 mg IV and 100 mg SC | - Exacerbation rate - ACQ-5 - AEs - SAEs |
NA |
| Powell and colleagues66 | Cochrane systematic review (mepolizumab versus placebo) | 8 studies on 1707 participants with asthma | 2.5 mg/kg or 10 mg/kg, or 75 mg, 250 mg and 750 mg IV, and 100 mg SC | - HRQoL - Asthma exacerbation - SAEs |
- FEV1
- PEF - Asthma symptoms - AEs - Eosinophil counts in peripheral blood, sputum or bronchioalveolar lavage fluid |
| Farne and colleagues10 | Cochrane systematic review (anti-IL-5s comparison) | 13 studies on 6000 participants with asthma (mepolizumab = 4; reslizumab = 4; benralizumab = 5) | 75 mg, 250 mg and 750 mg IV, and 100 mg SC | - Clinical significant asthma exacerbations | - Asthma exacerbation requiring hospital admission - ACQ-5 - Juniper’s AQLQ score - SGRQ score - FEV1 - SAEs - AEs - Blood eosinophil count. |
ACQ, asthma control questionnaire; ACQ-5, asthma control questionnaire 5 items; AE, adverse event; AQLQ, asthma quality of life questionnaire; DBPC, double-blind placebo-controlled; DREAM, Dose Ranging Efficacy And safety with Mepolizumab in severe asthma; FEV1, forced expiratory volume in 1 s; HRQoL, health-related quality of life; IgE, immunoglobulin E; MENSA, MEpolizumab as adjuNctive therapy in patients with Severe Asthma; NA, not applicable; OCS, oral corticosteroid; PEF, peak expiratory flow; ref., references in text; SAE, serious adverse event; SC, subcutaneous; SGRQ, St. George’s respiratory questionnaire; SIRUS, steroid reduction with mepolizumab study; IV, intravenous.