Safety and efficacy of monoclonal antibodies targeting IL-5 in severe eosinophilic asthma: A systematic review and meta-analysis of randomized controlled trials

Abstract

Recently, mepolizumab and benralizumab have been approved for the treatment of severe eosinophilic asthma. Thus, the main objective of the current study was to find out the exact efficacy and safety profile of mepolizumab and benralizumab in severe eosinophilic asthma. The relevant randomized controlled trials were searched in PubMed and clinical trials websites from inception to January 2022. All the analysis were done using RevMan5. There is a significant reduction of asthma exacerbation in the mepolizumab and benralizumab group. However, there is no significant differences were observed in the FEV1 change. Overall adverse drug reactions (ADRs) such as headache and injection site reactions are found non-significant in the mepolizumab and benralizumab group, however, bronchitis, nasopharyngitis, upper respiratory tract infection (URTI), sinusitis, and serious adverse event (SAEs) were found to be significantly less. The subgroup analysis has also shown a similar kind of efficacy in the mepolizumab and benralizumab group however, safety analysis results have shown better safer profile of benralizumab as compared to mepolizumab. The sensitivity analysis results have shown non-alteration in the conclusion of the study regarding efficacy parameters however, overall adverse events, sinusitis, and nasopharyngitis results are altered after the exclusion of outliers. Mepolizumab and benralizumab appear to be safe and effective in treatment of severe eosinophilic asthma. However, more data is required to draw a valid conclusion, particularly with mepolizumab.