Efficacy and safety of treatment with dupilumab for severe asthma : A systematic review of the EAACI guidelines-Recommendations on the use of biologicals in severe asthma

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dc.contributor.author Agache, Ioana
dc.contributor.author Song, Yang
dc.contributor.author Rocha, Claudio
dc.contributor.author Beltran, Jessica
dc.contributor.author Posso, Margarita
dc.contributor.author Steiner, Corinna
dc.contributor.author Alonso-Coello, Pablo
dc.contributor.author Akdis, Cezmi
dc.contributor.author Akdis, Mubeccel
dc.contributor.author Canonica, Giorgio Walter
dc.contributor.author Casale, Thomas
dc.contributor.author Chivato, Tomas
dc.contributor.author Corren, Jonathan
dc.contributor.author del Giacco, Stefano
dc.contributor.author Eiwegger, Thomas
dc.contributor.author Firinu, Davide
dc.contributor.author Gern, James E.
dc.contributor.author Hamelmann, Eckard
dc.contributor.author Hanania, Nicola
dc.contributor.author Mäkelä, Mika
dc.contributor.author Martin, Irene Hernandez
dc.contributor.author Nair, Parameswaran
dc.contributor.author O'Mahony, Liam
dc.contributor.author Papadopoulos, Nikolaos G.
dc.contributor.author Papi, Alberto
dc.contributor.author Park, Hae-Sim
dc.contributor.author de Llano, Luis Perez
dc.contributor.author Quirce, Santiago
dc.contributor.author Sastre, Joaquin
dc.contributor.author Shamji, Mohamed
dc.contributor.author Schwarze, Jurgen
dc.contributor.author Canelo-Aybar, Carlos
dc.contributor.author Palomares, Oscar
dc.contributor.author Jutel, Marek
dc.date.accessioned 2021-02-17T22:53:32Z
dc.date.available 2021-12-17T03:45:26Z
dc.date.issued 2020-05
dc.identifier.citation Agache , I , Song , Y , Rocha , C , Beltran , J , Posso , M , Steiner , C , Alonso-Coello , P , Akdis , C , Akdis , M , Canonica , G W , Casale , T , Chivato , T , Corren , J , del Giacco , S , Eiwegger , T , Firinu , D , Gern , J E , Hamelmann , E , Hanania , N , Mäkelä , M , Martin , I H , Nair , P , O'Mahony , L , Papadopoulos , N G , Papi , A , Park , H-S , de Llano , L P , Quirce , S , Sastre , J , Shamji , M , Schwarze , J , Canelo-Aybar , C , Palomares , O & Jutel , M 2020 , ' Efficacy and safety of treatment with dupilumab for severe asthma : A systematic review of the EAACI guidelines-Recommendations on the use of biologicals in severe asthma ' , Allergy : European journal of allergy and clinical immunology , vol. 75 , no. 5 , pp. 1058-1068 . https://doi.org/10.1111/all.14268
dc.identifier.other PURE: 136307516
dc.identifier.other PURE UUID: 9c3c622a-12fe-4b55-b7c6-d222cb87dfd0
dc.identifier.other WOS: 000522767500001
dc.identifier.other ORCID: /0000-0002-2933-3111/work/76332178
dc.identifier.uri http://hdl.handle.net/10138/326686
dc.description.abstract Dupilumab, a fully human monoclonal antibody against interleukin-4 receptor alpha, is approved as add-on maintenance treatment for inadequately controlled type 2 severe asthma. This systematic review evaluated the efficacy, safety and economic impact of dupilumab compared to standard of care for uncontrolled severe asthma. PubMed, EMBASE and Cochrane Library were searched for RCTs and health economic evaluations. Critical and important asthma-related outcomes were evaluated. The risk of bias and the certainty of the evidence were assessed using GRADE. Three RCTs including 2735 subjects >12 years old and 24-52 weeks of follow-up were included. Dupilumab reduced with high certainty severe asthma exacerbations (Incidence rate ratio 0.51; 95% CI 0.45-0.59) and the percentage use of oral corticosteroid use (mean difference (MD) -28.2 mg/d; 95% CI -40.7 to -15.7). Asthma control (ACQ-5), quality of life (AQLQ) and rescue medication use [puffs/d] improved, without reaching the minimal important clinical difference: ACQ-5 MD -0.28 (95% CI -0.39 to -0.17); AQLQ MD +0.28 (95% CI 0.20-0.37); and rescue medication MD -0.35 (95% CI -0.73 to +0.02). FEV1 increased (MD +0.15; 95% CI +0.11 to +0.18) (moderate certainty). There was an increased rate of dupilumab-related adverse events (AEs) (moderate certainty) and of drug-related serious AEs (low certainty). The incremental cost-effectiveness ratio of dupilumab versus standard therapy was 464 000$/QALY (moderate certainty). More data on long-term safety are needed both for children and for adults, together with more efficacy data in the paediatric population. en
dc.format.extent 11
dc.language.iso eng
dc.relation.ispartof Allergy : European journal of allergy and clinical immunology
dc.rights unspecified
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject cost-effectiveness
dc.subject dupilumab
dc.subject exacerbations
dc.subject oral corticosteroids
dc.subject severe asthma
dc.subject QUALITY
dc.subject BURDEN
dc.subject INFORMATION
dc.subject SURROGATES
dc.subject EURONHEED
dc.subject CONSENSUS
dc.subject GRADE
dc.subject FENO
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title Efficacy and safety of treatment with dupilumab for severe asthma : A systematic review of the EAACI guidelines-Recommendations on the use of biologicals in severe asthma en
dc.type Review Article
dc.contributor.organization HUS Inflammation Center
dc.contributor.organization Department of Dermatology, Allergology and Venereology
dc.contributor.organization University of Helsinki
dc.contributor.organization Helsinki University Hospital Area
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1111/all.14268
dc.relation.issn 0105-4538
dc.rights.accesslevel openAccess
dc.type.version acceptedVersion

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