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

Paola Rogliani, Maria Gabriella Matera, Ermanno Puxeddu, Marco Mantero, Francesco Blasi, Mario Cazzola, Luigino Calzetta

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)28-37
Number of pages10
JournalPulmonary Pharmacology and Therapeutics
Volume50
DOIs
Publication statusPublished - Jun 1 2018

Keywords

  • Benralizumab
  • COPD
  • Mepolizumab
  • Meta-analysis
  • Monoclonal antibodies

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Biochemistry, medical
  • Pharmacology (medical)

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