Emerging biological therapies for treating chronic obstructive pulmonary disease: A pairwise and network meta-analysis.

Abstract

Inflammation in chronic obstructive pulmonary disease (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 clicnial 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.

• Authors: Paola Rogliani, Maria Gabriella Matera, Ermanno Puxeddu, Marco Mantero, Francesco Blasi, Mario Cazzola, Luigino Calzetta
• Journal: Pulmonary pharmacology & therapeutics (Pulm Pharmacol Ther) Vol. 50 Pg. 28-37 (06 2018) ISSN: 1522-9629 [Electronic] England
• PMID: 29609004 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Ltd. All rights reserved.

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Bronchodilator Agents
• Chemokines
• canakinumab
• benralizumab
• mepolizumab
• Infliximab

Topics

• Aged
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Bronchodilator Agents (therapeutic use)
• Chemokines (antagonists & inhibitors)
• Female
• Humans
• Infliximab (therapeutic use)
• Male
• Middle Aged
• Network Meta-Analysis
• Pulmonary Disease, Chronic Obstructive (drug therapy)
• Randomized Controlled Trials as Topic
• Respiratory Function Tests
• Surveys and Questionnaires