Summary of findings 2. Mepolizumab 300 mg compared with placebo for chronic obstructive pulmonary disease.
| Mepolizumab 300 mg compared with placebo for chronic obstructive pulmonary disease | ||||||
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Patient or population: individuals with COPD Settings: outpatient Intervention: mepolizumab 300 mg Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Mepolizumab 300 mg | |||||
| Rate of moderate or severe exacerbations Eosinophilic phenotype |
1.49 moderate or severe exacerbations per year | 1.28 (1.04 to 1.58) moderate or severe exacerbations per year | Rate ratio 0.86 (0.70 to 1.06) | 451 (1 RCT) | ⊕⊕⊕⊖ Moderatea |
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| Time to first moderate or severe exacerbation Eosinophilic phenotype |
‐ | ‐ | Hazard ratio 0.77 (0.60 to 0.99) | 451 (1 RCT) | ⊕⊕⊕⊖ Moderatea |
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| Rate of exacerbations with ED visit or hospitalisations Eosinophilic phenotype |
0.28 exacerbations with ED visit per year | 0.23 (0.14 to 0.38) exacerbations with ED visit per year | Rate ratio 0.83 (0.51 to 1.35) | 451 (1 RCT) | ⊕⊕⊕⊖ Moderatea |
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| Serious adverse events | 68 serious adverse events out of 226 participants | 60 serious adverse events out of 225 participants | Odds ratio 0.84 (0.56 to 1.27) | 451 (1 RCT) | ⊕⊕⊕⊖ Moderatea |
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| Health‐related quality of life: change in SGRQ total score Scale: 0 to 100 (lower is better) Eosinophilic phenotype |
‐ | The MD was −0.10 lower (−2.80 to 2.60). | ‐ | 451 (1 RCT) | ⊕⊕⊕⊖ Moderatea |
A change of ≥ 4 is considered the minimum clinically significant difference. |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; COPD: chronic obstructive pulmonary disease; ED: emergency department; MD: mean difference; RCT: randomised controlled trial; SGRQ: St George's Respiratory Questionnaire | ||||||
| GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded once as this is a single study. The true effect is likely to be close to the estimate of the effect, but further studies could be substantially different.