In Pulmonary Pharmacology & Therapeutics was published meta-analysis by great Italian team on hot topic Emerging biological therapies for treating chronic obstructive pulmonary disease: A pairwise and network meta-analysis.
Inflammation in COPD is often corticosteroid resistant and, thus, alternative
anti-inflammatory approaches are needed. Since it is still not clear
whether blocking specific pro-inflammatory factors may provide clinical
benefit in COPD, we have performed a meta-analysis to quantify the
impact of monoclonal antibodies (mABs) targeting the
cytokine/chemokine-mediated inflammation in COPD.
A
pairwise and network meta-analyses were performed by extracting data
from randomized clinical trials on COPD concerning the impact of mABs
vs. placebo on the risk of exacerbation, forced expiratory volume in 1 s
(FEV1), and St. George's Respiratory Questionnaire (SGRQ).
Data
on the interleukin (IL)-1β antagonist canakinumab, IL-1R1 antagonist
MEDI8986, IL-5 antagonist mepolizumab, IL-5R antagonist benralizumab,
IL-8 antagonist ABX-IL8, and TNF-α antagonist infliximab were found.
Overall, mAB therapy had a moderate impact on the risk exacerbation, but
not on FEV1 and SGRQ. The pairwise meta-analysis performed
in eosinophilic patients, and the network approach, indicated that
mepolizumab elicited a beneficial effect against the risk of
exacerbation, whereas benralizumab was more effective in improving both
FEV1 and SGRQ.
This study demonstrates that targeting the pathway activated by IL-5 may have a beneficial impact in eosinophilic COPD patients.
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