Cochrane · systematic review · CD010834
Anti‐IL‐5 therapies for asthma
Farne, HA, Wilson, A, Milan, S, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
36
current version
GRADE rated
36
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 2 · 5.6%High 34 · 94.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyMepolizumab subcutaneous (SC) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of clinically significant exacerbations requiring systemic corticosteroids Mepolizumab subcutaneous (SC) vs placebo | Rate ratio 0.45 [0.36, 0.55] | 2 studies · 936 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Mepolizumab subcutaneous (SC) vs placebo | Rate ratio 0.36 [0.2, 0.66] | 2 studies · 936 participants | High |
Health‐related quality of life (ACQ)Scale from: 0‐6 (lower is better) Mepolizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 1231 participants | High |
Health‐related quality of life (SGRQ)Scale from: 0‐100 (lower is better) Mepolizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 1231 participants | High |
Pre‐bronchodilator FEV1 Mepolizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 1231 participants | High |
Serious adverse events Mepolizumab subcutaneous (SC) vs placebo | Risk ratio 0.68 [0.46, 1.01] | 3 studies · 1231 participants | High |
Clinically significant adverse events leading to discontinuation Mepolizumab subcutaneous (SC) vs placebo | Risk ratio 0.6 [0.19, 1.85] | 3 studies · 1231 participants | High |
Mepolizumab intravenous (IV) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of clinically significant exacerbations requiring systemic corticosteroids Mepolizumab intravenous (IV) vs placebo | Rate ratio 0.53 [0.44, 0.64] | 3 studies · 751 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Mepolizumab intravenous (IV) vs placebo | Rate ratio 0.52 [0.31, 0.87] | 2 studies · 690 participants | High |
Health‐related quality of life (AQLQ)Scale from: 1‐7 (higher is better) Mepolizumab intravenous (IV) vs placebo | no estimate extracted | 2 studies · 369 participants | High |
Health‐related quality of life (ACQ)Scale from: 0‐6 (lower is better) Mepolizumab intravenous (IV) vs placebo | no estimate extracted | 2 studies · 369 participants | High |
Pre‐bronchodilator FEV1 (L) Mepolizumab intravenous (IV) vs placebo | no estimate extracted | 2 studies · 690 participants | High |
Serious adverse events Mepolizumab intravenous (IV) vs placebo | Risk ratio 0.59 [0.37, 0.94] | 3 studies · 751 participants | High |
Clinically significant adverse events leading to discontinuation Mepolizumab intravenous (IV) vs placebo | Risk ratio 0.72 [0.18, 2.92] | 3 studies · 751 participants | High |
Reslizumab intravenous (IV) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of clinically significant exacerbations requiring systemic corticosteroids Reslizumab intravenous (IV) vs placebo | Rate ratio 0.43 [0.33, 0.55] | 2 studies · 953 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Reslizumab intravenous (IV) vs placebo | Rate ratio 0.67 [0.39, 1.17] | 2 studies · 953 participants | High |
Health‐related quality of life (AQLQ)Scale from: 1‐7 (higher is better) Reslizumab intravenous (IV) vs placebo | no estimate extracted | 3 studies · 1164 participants | High |
Health‐related quality of life (ACQ)Scale from: 0 to 6 (lower is better) Reslizumab intravenous (IV) vs placebo | no estimate extracted | 4 studies · 1652 participants | High |
Pre‐bronchodilator FEV1 (L) Reslizumab intravenous (IV) vs placebo | no estimate extracted | 4 studies · 1652 participants | High |
Serious adverse events Reslizumab intravenous (IV) vs placebo | Risk ratio 0.79 [0.56, 1.12] | 4 studies · 1656 participants | High |
Clinically significant adverse events leading to discontinuation Reslizumab intravenous (IV) vs placebo | Risk ratio 0.66 [0.43, 1.02] | 4 studies · 1659 participants | High |
Reslizumab subcutaneous (SC) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of clinically significant exacerbations requiring systemic corticosteroids Reslizumab subcutaneous (SC) vs placebo | Rate ratio 0.79 [0.56, 1.11] | 1 study · 464 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Reslizumab subcutaneous (SC) vs placebo | Rate ratio 0.94 [0.43, 2.05] | 1 study · 464 participants | High |
Health‐related quality of life (AQLQ)Scale from: 1‐7 (higher is better) Reslizumab subcutaneous (SC) vs placebo | no estimate extracted | 1 study · 464 participants | High |
Health‐related quality of life (ACQ)Scale from: 0 to 6 (lower is better) Reslizumab subcutaneous (SC) vs placebo | no estimate extracted | 1 study · 464 participants | High |
Health‐related quality of life (SGRQ)Scale from: 0 to 100 (lower is better) Reslizumab subcutaneous (SC) vs placebo | no estimate extracted | 1 study · 464 participants | High |
Pre‐bronchodilator FEV1 (L) Reslizumab subcutaneous (SC) vs placebo | no estimate extracted | 1 study · 46 participants | High |
Serious adverse events Reslizumab subcutaneous (SC) vs placebo | Risk ratio 0.97 [0.53, 1.79] | 1 study · 464 participants | High |
Clinically significant adverse events leading to discontinuation Reslizumab subcutaneous (SC) vs placebo | Risk ratio 4.87 [0.57, 41.4] | 1 study · 464 participants | Moderate Downgraded: imprecision |
Benralizumab subcutaneous (SC) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of clinically significant exacerbations requiring systemic corticosteroids Benralizumab subcutaneous (SC) vs placebo | Rate ratio 0.59 [0.52, 0.66] | 4 studies · 3112 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Benralizumab subcutaneous (SC) vs placebo | Rate ratio 0.68 [0.47, 0.98] | 2 studies · 1537 participants | Moderate Downgraded: inconsistency |
Health‐related quality of life (AQLQ)Scale from: 1‐7 (higher is better) Benralizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 1541 participants | High |
Health‐related quality of life (ACQ)Scale from: 0‐6 (lower is better) Benralizumab subcutaneous (SC) vs placebo | no estimate extracted | 4 studies · 2791 participants | High |
Pre‐bronchodilator FEV1 (L) Benralizumab subcutaneous (SC) vs placebo | no estimate extracted | 4 studies · 2786 participants | High |
Serious adverse events Benralizumab subcutaneous (SC) vs placebo | Risk ratio 0.76 [0.62, 0.93] | 5 studies · 3304 participants | High |
Clinically significant adverse events leading to discontinuation Benralizumab subcutaneous (SC) vs placebo | Risk ratio 2.04 [1.03, 4.03] | 4 studies · 3253 participants | High |
Mepolizumab subcutaneous (SC) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of exacerbations requiring systemic corticosteroids Mepolizumab subcutaneous (SC) vs placebo | Rate ratio 0.45 [0.36, 0.55] | 2 studies · 936 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Mepolizumab subcutaneous (SC) vs placebo | Rate ratio 0.36 [0.2, 0.66] | 2 studies · 936 participants | High |
Health‐related quality of life (ACQ) Scale from: 0 to 6 (lower is better) Mepolizumab subcutaneous (SC) vs placebo | no estimate extracted | 2 studies · 936 participants | Moderate |
Health‐related quality of life (SGRQ) Scale from: 0 to 100 (lower is better) Mepolizumab subcutaneous (SC) vs placebo | no estimate extracted | 2 studies · 936 participants | High |
Pre‐bronchodilator FEV1 (L) Mepolizumab subcutaneous (SC) vs placebo | no estimate extracted | 2 studies · 936 participants | High |
Adverse events leading to discontinuation Mepolizumab subcutaneous (SC) vs placebo | Risk ratio 0.45 [0.11, 1.8] | 2 studies · 936 participants | Moderate Downgraded: imprecision |
Mepolizumab intravenous (IV) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of clinically significant exacerbations Mepolizumab intravenous (IV) vs placebo | Rate ratio 0.53 [0.44, 0.64] | 3 studies · 751 participants | Moderate Downgraded: indirectness |
Rate of exacerbations requiring emergency department treatment or admission Mepolizumab intravenous (IV) vs placebo | Rate ratio 0.52 [0.31, 0.87] | 2 studies · 690 participants | Moderate Downgraded: indirectness |
Health‐related quality of life (AQLQ) Scale from: 1 to 7 (higher is better) Mepolizumab intravenous (IV) vs placebo | no estimate extracted | 2 studies · 677 participants | Moderate Downgraded: indirectness |
Health‐related quality of life (ACQ) Scale from: 0 to 6 (lower is better) Mepolizumab intravenous (IV) vs placebo | no estimate extracted | 2 studies · 369 participants | Moderate Downgraded: indirectness |
Pre‐bronchodilator FEV1 (L) Mepolizumab intravenous (IV) vs placebo | no estimate extracted | 2 studies · 690 participants | Moderate Downgraded: indirectness |
Adverse events leading to discontinuation Mepolizumab intravenous (IV) vs placebo | RR 0.72 [0.18, 2.92] | 3 studies · 751 participants | Moderate Downgraded: indirectness |
Reslizumab intravenous (IV) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of exacerbations requiring systemic corticosteroids Reslizumab intravenous (IV) vs placebo | Rate ratio 0.43 [0.33, 0.55] | 2 studies · 953 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Reslizumab intravenous (IV) vs placebo | Rate ratio 0.67 [0.39, 1.17] | 2 studies · 953 participants | High |
Health‐related quality of life (AQLQ) Scale from: 1 to 7 (higher is better) Follow ‐p: range 16 weeks to 52 weeks Reslizumab intravenous (IV) vs placebo | no estimate extracted | 3 studies · 1164 participants | High |
Health‐related quality of life (ACQ) Scale from: 0 to 6 (lower is better) Reslizumab intravenous (IV) vs placebo | no estimate extracted | 4 studies · 1652 participants | High |
Pre‐bronchodilator FEV1 (L) Reslizumab intravenous (IV) vs placebo | no estimate extracted | 4 studies · 1652 participants | High |
Serious adverse events Reslizumab intravenous (IV) vs placebo | RR 0.79 [0.56, 1.12] | 4 studies · 1656 participants | High |
Adverse events leading to discontinuation Reslizumab intravenous (IV) vs placebo | RR 0.66 [0.43, 1.02] | 4 studies · 1659 participants | High |
Benralizumab subcutaneous (SC) compared to placebo for asthma
Population: people with asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of exacerbations requiring systemic corticosteroids Benralizumab subcutaneous (SC) vs placebo | Rate ratio 0.62 [0.55, 0.7] | 3 studies · 2456 participants | High |
Rate of exacerbations requiring emergency department treatment or admission Benralizumab subcutaneous (SC) vs placebo | Rate ratio 0.68 [0.47, 0.98] | 2 studies · 1537 participants | Moderate Downgraded: inconsistency |
Health‐related quality of life (AQLQ) Scale from: 1 to 7 (higher is better) Benralizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 1541 participants | High |
Health‐related quality of life (ACQ) Scale from: 0 to 6 (lower is better) Benralizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 2359 participants | High |
Pre‐bronchodilator FEV1 (L) Benralizumab subcutaneous (SC) vs placebo | no estimate extracted | 3 studies · 2355 participants | High |
Serious adverse events Benralizumab subcutaneous (SC) vs placebo | RR 0.81 [0.66, 1.01] | 4 studies · 2648 participants | High |
Adverse events leading to discontinuation Benralizumab subcutaneous (SC) vs placebo | RR 2.15 [1.02, 4.57] | 3 studies · 2597 participants | High |
Intravenous mepolizumab compared to placebo for asthma
Population: adults with asthma of varying degrees of severity
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in HRQoL Intravenous mepolizumab vs placebo | no estimate extracted | 2 studies · 682 participants | Low Downgraded: indirectness |
Change in HRQoL Intravenous mepolizumab vs placebo | no estimate extracted | 1 study · 382 participants | Moderate Downgraded: indirectness |
Rate of clinically significant exacerbations ‐ 75 mg mepolizumab versus placebo Intravenous mepolizumab vs placebo | Rate ratio 0.52 [0.43, 0.64] | 2 studies · 690 participants | Moderate Downgraded: indirectness |
Rate of clinically significant exacerbations ‐ 250 mg mepolizumab versus placebo Intravenous mepolizumab vs placebo | Rate ratio 0.61 [0.46, 0.81] | 1 study · 307 participants | Moderate Downgraded: indirectness |
Rate of clinically significant exacerbations ‐ 750 mg mepolizumab versus placebo Intravenous mepolizumab vs placebo | Rate ratio 0.48 [0.36, 0.64] | 1 study · 311 participants | Moderate Downgraded: indirectness |
People with one or more exacerbations Intravenous mepolizumab vs placebo | Risk ratio 0.67 [0.34, 1.31] | 4 studies · 467 participants | Low Downgraded: imprecision, indirectness |
Serious adverse events Intravenous mepolizumab vs placebo | Risk ratio 0.49 [0.3, 0.8] | 5 studies · 1441 participants | Moderate Downgraded: indirectness |
Subcutaneous mepolizumab compared to placebo for asthma
Population: adults with severe eosinophilic asthma
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Change in HRQoL Subcutaneous mepolizumab vs placebo | no estimate extracted | 1 study · 385 participants | Moderate Downgraded: imprecision |
Rate of exacerbations requiring admission Subcutaneous mepolizumab vs placebo | Rate ratio 0.31 [0.11, 0.91] | 1 study · 385 participants | Moderate Downgraded: imprecision |
Rate of exacerbations requiring ED or admission Subcutaneous mepolizumab vs placebo | Rate ratio 0.39 [0.18, 0.83] | 1 study · 385 participants | Moderate Downgraded: imprecision |
Rate of clinically significant exacerbations Subcutaneous mepolizumab vs placebo | Rate ratio 0.47 [0.35, 0.63] | 1 study · 385 participants | Moderate Downgraded: imprecision |
Asthma symptoms measured on Asthma Control Questionnaire Scale from: 0 to 6 (lower is better)b Subcutaneous mepolizumab vs placebo | no estimate extracted | 1 study · 385 participants | Low Downgraded: imprecision |