A Comparison of Adverse Effect Profiles of Two Anti-IL-5 Therapies in Adults with Uncontrolled Asthma

―A Network Meta-analysis of Phase 3 Trials―

抄録

The aim of this study was to compare the adverse effect profiles of mepolizumab（MPZ）and benralizumab（BRZ）in adults with uncontrolled asthma. A network meta-analysis of phase 3 trials was conducted to compare the adverse effects of MPZ and BRZ in patients with uncontrolled asthma. The MEDLINE-PubMed, Scopus and the Cochrane library databases were searched to identify any relevant articles. The outcome measures of fatal adverse events, headache, and injection site reaction are presented as odds ratios（ORs）with 95％ confidence intervals（CIs）. The surface under the cumulative curve（SUCRA）for each outcome was also compared among MPZ, BRZ, and placebo treatments. Four randomized controlled trials of MPZ（100mg s/c every four weeks）（100-MPZ）or BRZ（30mg s/c every eight weeks）（30-BRZ）met the criteria for inclusion in the study. The ORs and 95％ CIs of 100-MPZ compared with BRZ for fatal adverse events, headache, and injection site reaction were 0.26（0.01-4.90）, 0.79（0.40-1.54）, and 2.32（0.79-6.80）, respectively. SUCRAs for 100-MPZ, 30-BRZ, and placebo were 0.8, 0.3, and 0.4 for fatal adverse events, 0.5, 0.1, and 0.8 for headache, and 0.0, 0.6, and 0.8 for injection site reaction, respectively. There were no significant differences in the incidence of fatal adverse events, headache, and injection site reaction between MPZ and BRZ treatment. However, the SUCRA values indicate an association between administration of BRZ and the occurrence of fatal adverse event or headache, or between administration of MPZ and the occurrence of injection site reaction. Moreover, the incidence odds of injection site reaction were significantly higher in the MPZ group than in the placebo group. Further analysis will be needed to clarify the details of safety profiles of these anti-IL-5 therapies.