Journal of Asthma and Allergy (Nov 2022)

Tezepelumab for Patients with Severe Uncontrolled Asthma: A Systematic Review and Meta-Analysis

  • Zoumot Z,
  • Al Busaidi N,
  • Tashkandi W,
  • Aljohaney AA,
  • Isse S,
  • Vidyasagar K,
  • Ukwaja KN

Journal volume & issue
Vol. Volume 15
pp. 1665 – 1679

Abstract

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Zaid Zoumot,1 Nasser Al Busaidi,2 Wail Tashkandi,3 Ahmed A Aljohaney,4 Said Isse,1 Kota Vidyasagar,5 Kingsley Nnanna Ukwaja6 1Respiratory Institute Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; 2Department of Pulmonology, Royal Hospital, Muscat, Sultanate of Oman; 3Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 5Department of Pharmacy, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, Telangana, 506009, India; 6Department of Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, NigeriaCorrespondence: Zaid Zoumot, Respiratory Institute Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates, Email [email protected]: Tezepelumab is a human monoclonal antibody that blocks thymic stromal lymphopoietin, an epithelial-cell-derived cytokine implicated in the pathogenesis of asthma. It was approved by the United States Federal Drug Administration (US FDA) as an add-on maintenance treatment for patients with severe uncontrolled asthma in December 2021. We conducted a systematic review and meta-analysis to investigate the safety and efficacy of tezepelumab on forced expiratory volume (FEV1) (L), the rate of asthma exacerbations, health-related quality of life, fractional exhaled nitric oxide (FeNO) (ppb), and blood eosinophil count (cells/mL) in patients with severe, uncontrolled asthma. Mean changes for efficacy and proportions (safety) with their corresponding 95% confidence intervals (CIs) were used to provide pooled estimates. A total of six randomized controlled trials comprising 2667 patients were included, of whom 1610 were treated with tezepelumab and 1057 received placebo. The pooled analysis showed that tezepelumab treatment resulted in an improvement in FEV1 of 0.15 L (95% CI: 0.12 to 0.17), a reduction in the asthma exacerbation rate per year of 0.60 (95% CI: 0.51 to 0.70), and a reduction in FeNO of − 12.41 ppb (95% CI: − 14.28 to − 10.53) when compared to placebo. Improvements in FEV1 and FeNO levels were maintained at 24 and 52 weeks. As for safety, patients did not experience a higher incidence of adverse drug reactions with tezepelumab (0.79 (95% CI: 0.55 to 1.12)) as compared to placebo. As for quality of life, different doses of the tezepelumab intervention group depicted non-significant improvement in the QoL, from 0.15 (95% CI: − 0.09 to 0.38) for 70 mg, 0.18 (95% CI: − 0.10 to 0.46) for 210 mg, 0.08 (95% CI: − 0.16 to 0.32) for 280 mg as compared to the placebo. Tezepelumab significantly reduced exacerbation rates and improved FEV1 with an acceptable safety profile.Keywords: tezepelumab, asthma, quality of life, systematic review, meta-analysis

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