Omalizumab versus Mepolizumab as add-on therapy in asthma patients not well controlled on at least an inhaled corticosteroid: A network meta-analysis.
OBJECTIVE
The purpose of this study is to examine the comparative efficacy of Omalizumab (OMA) and Mepolizumab (Mepo) in the treatment of severe asthma by performing a network meta-analysis.


METHOD
Data Sources: A systematic review of the literature was performed through four databases from their inception to February 2016.


STUDY SELECTIONS
Randomized control trials and cohort studies were considered if they addressed the individual efficacy of OMA and Mepo in the treatment of asthma that was not well controlled on inhaled corticosteroids (ICSs) with or without other agents.


RESULTS
OMA was significantly better than Mepo in improving the Asthma Quality of Life Questionnaire with a mean difference of 0.38 and a confidence interval of (0.21-0.55), p < 0.0001, without reaching the minimal clinically important difference of 0.5. No significant difference was seen in Asthma Control Questionnaire, forced expiratory volume in second 1 (FEV1), and Peak Expiratory Flow Rate (PEFR) improvement from baseline. Both medications were successful in reducing the calculated annualized rates of asthma exacerbations (AEs) vs placebo by approximately 50%. The heterogeneity score for the different comparisons were elevated except for the PEFR.


CONCLUSION
When compared indirectly via a network meta-analysis, the efficacy of OMA and Mepo was similar in the treatment of asthma that was not well controlled on at least high-dose ICS. The high heterogeneity observed and the different selection criteria for the use of the two drugs do not permit us to make any definitive recommendations for the preferential use of OMA vs Mepo in the patient populations studied. However, the current data do not suggest any major differences in efficacy.
['Nachef|Zahi|Z|', 'Krishnan|Amita|A|', 'Mashtare|Terry|T|', 'Zhuang|Tingting|T|', 'Mador|M Jeffery|MJ|']
D000280:Administration, Inhalation D018927:Anti-Asthmatic Agents D061067:Antibodies, Monoclonal, Humanized D001249:Asthma D018450:Disease Progression D005938:Glucocorticoids D006801:Humans D008168:Lung D000071076:Network Meta-Analysis D000069444:Omalizumab D010366:Peak Expiratory Flow Rate D011788:Quality of Life D016032:Randomized Controlled Trials as Topic D016896:Treatment Outcome
Omalizumab Mepolizumab Asthma treatment review