Asthma: omalizumab, mepolizumab similarly effective as add-on therapy

Takeaway
  • Omalizumab (Xolair) and mepolizumab (Nucala) showed similar efficacy in patients with asthma that was not well controlled on inhaled corticosteroids (ICS) with or without other agents.

Why this matters

  • To date, there has been no direct comparison study to assess the efficacy of omalizumab and mepolizumab as add-on therapy in patients with asthma. 
  • This is the first meta-analysis to compare the 2 agents in patients with asthma. 
  • Based on available evidence, neither drug can be recommended over the other in patients who qualify for both.

Study design

  • Network meta-analysis of 18 studies (4854 patients) evaluating omalizumab and 4 studies (1620 patients) evaluating mepolizumab since inception till February 2016 met the eligibility criteria.
  • Funding: None disclosed.

Key results

  • Mean difference (MD) in FEV improvement between omalizumab and mepolizumab was 9.3 mL (P=1).
  • Improvement in morning Peak Expiratory Flow Rate and Asthma Control Questionnaire score was similar in both groups (MD, 6.24 L/min [P=.72] and MD, −0.02 [P=1], respectively).

Limitations

  • Heterogeneity between studies.
Coauthored with Deepa Koli, M.Pharmacy

Nachef Z, Krishnan A, Mashtare T, Zhuang T, Mador MJ. Omalizumab versus Mepolizumab as add-on therapy in asthma patients not well controlled on at least an inhaled corticosteroid: A network meta-analysis. J Asthma. 2017 May 1 [Epub ahead of print]. doi: 10.1080/02770903.2017.1306548. PMID: 28459601

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