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• W2894860435 abstract "SESSION TITLE: Medications and the Treatment of Obstructive Lung Disease SESSION TYPE: Original Investigations PRESENTED ON: 10/10/2018 08:45 AM - 09:45 AM PURPOSE: Chronic obstructive pulmonary disease (COPD) is a disease with predominance of neutrophilic airway inflammation but approximately 20-40% of patients have elevated eosinophils in their airways presenting with >3% sputum eosinophilia. Benefits of newer biologic therapies such as anti-interleukin 5 (IL5) agents (Mepolizumab and Benralizumab) have been studied in few randomized controlled trials but with contrasting results. At the time of conceptualization, there is no meta-analysis assessing the efficacy and safety of these agents in the eosinophilic phenotype of COPD. METHODS: We did a review and meta-analysis of randomized controlled trials on the use of anti-interleukin 5 in moderate to severe patients with eosinophilic COPD versus placebo. The primary outcome is annual exacerbation rate. Secondary outcomes include reduction of blood and sputum eosinophilia, improvement in lung function, change in symptom and quality of life scores and adverse events. RESULTS: This analysis included 4 randomized controlled trials (3 for Mepolizumab and 1 for Benralizumab) with a total patient population of 1,236 eosinophilic COPD patients. Compared with placebo, there is a significant decrease in the annual exacerbation rate (mean difference -0.24 [-0.35 to -0.13]) and significant decrease in sputum eosinophilia (mean difference 4.09 [-6.61 to 14.78]) in patients who were given anti-IL5 treatment. There is a significant improvement in COPD Assessment Test (CAT) scores (mean difference -0.79 [-1.37, -0.21]). Treatment with anti-IL5 agents show an insignificant trend toward longer time to exacerbations (HR 2.18 [0.71-6.70]). There is also no significant difference in lung function and Saint George’s Respiratory Questionnaire (SGRQ) scores. There is a trend toward increase in overall adverse events (AEs) with anti-IL5 treatment and a trend toward decreased serious AEs and AEs leading to discontinuation of therapy but both showed no significant difference. CONCLUSIONS: Therapy with Anti-IL5 agents clearly decrease exacerbation rates and sputum eosinophilia and improve quality of life in patients with eosinophilic COPD. Treatment shows equivocal findings regarding time to exacerbation and safety. Further updates on this subject must be done once more studies become available. More randomised controlled with similar outcomes of interest and additional trials on other anti-IL5 agents such as Reslizumab may be done to further assess the benefit and safety of these novel agents for COPD. CLINICAL IMPLICATIONS: Coupled with proper assessment of safety and applicability, adjunctive therapy with anti-IL5 agents appear to benefit eosinophilic COPD patients in terms of decreasing exacerbation and sputum eosinophilia with improvement in quality of life. DISCLOSURES: No relevant relationships by ANJULI MAY JAEN, source=Web Response No relevant relationships by Irene Rosellen Tan, source=Web Response no disclosure on file for Ralph Elvi Villalobos; No relevant relationships by Aileen Wang, source=Web Response" @default.
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• W2894860435 date "2018-10-01" @default.
• W2894860435 modified "2023-09-24" @default.
• W2894860435 title "ANTI-IL-5 AGENTS IN THE TREATMENT OF EOSINOPHILIC COPD: A SYSTEMATIC REVIEW AND META-ANALYSIS" @default.
• W2894860435 doi "https://doi.org/10.1016/j.chest.2018.08.684" @default.
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