Anti–IL-5 treatments in patients with severe asthma by blood eosinophil thresholds: Indirect treatment comparison William Busse, MD, Geoffrey Chupp,

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Presentation transcript:

Anti–IL-5 treatments in patients with severe asthma by blood eosinophil thresholds: Indirect treatment comparison William Busse, MD, Geoffrey Chupp, MD, Hiroyuki Nagase, PhD, Frank C. Albers, PhD, Scott Doyle, DPhil (Cand), Qin Shen, PhD, Daniel J. Bratton, PhD, Necdet B. Gunsoy, PhD Journal of Allergy and Clinical Immunology Volume 143, Issue 1, Pages 190-200.e20 (January 2019) DOI: 10.1016/j.jaci.2018.08.031 Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig 1 Overview of patients' baseline characteristics in the ITT populations and baseline blood eosinophil count subgroups used in the ITC. *Data for the end point of exacerbations requiring ED visits/hospitalizations were reported in the published reslizumab pooled analysis; patients had 2 or more exacerbations in the past year and GINA step 4/5 therapy. †Data for the 150 cells/μL or greater subgroup were reported in the published benralizumab pooled analysis only. ‡Because of the lack of available subgroup data for benralizumab, it was only possible to define a 450 cells/μL or greater subgroup. ICS, Inhaled corticosteroid; ITT, intent to treat. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig 2 ITC of the rate of clinically significant exacerbations by baseline blood eosinophil count subgroups and in the ITT population. *P < .05 and **P < .01. Comparisons are presented as drug A versus drug B. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. I2 values: 400 cells/μL or greater, 0% (MEPO vs PBO), NA (BENRA vs PBO), and 0% (RESLI vs PBO); 300 cells/μL or greater, 0% (MEPO vs PBO) and 73% (BENRA vs PBO); 150 cells/μL or greater, 0% (MEPO vs PBO) and NA (BENRA vs PBO); and unadjusted comparison, 0% (MEPO vs PBO), 73% (BENRA vs PBO), and 0% (RESLI vs PBO). BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; NA, not applicable; RESLI, 3 mg/kg reslizumab. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig 3 ITCs of the rate of exacerbations requiring ED visits/hospitalizations by baseline blood eosinophil count subgroup and in the ITT population. Comparisons are presented as drug A versus drug B. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. I2 values: 400 cells/μL or greater, 12% (MEPO vs PBO) and NA (RESLI vs PBO); 300 cells/μL or greater, 0% (MEPO vs PBO) and 86% (BENRA vs PBO); unadjusted comparison, 0% (MEPO vs PBO), 86% (BENRA vs PBO), and 0% (RESLI vs PBO). BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; NA, not applicable; PBO, placebo; RESLI, 3 mg/kg reslizumab. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig 4 ITCs of the change from baseline in ACQ score by baseline blood eosinophil count subgroups and in the ITT population. *P < .05 and **P < .01. Comparisons are presented as drug A versus drug B. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. I2 values: 400 cells/μL or greater, 28% (MEPO vs PBO), NA (BENRA vs PBO), and 0% (RESLI vs PBO); 300 cells/μL or greater, 60% (MEPO vs PBO) and 0% (BENRA vs PBO); 150 cells/μL or greater, 0% (MEPO vs PBO) and NA (BENRA vs PBO); unadjusted comparison, 0% (MEPO vs PBO), 0% (BENRA vs PBO), and 0% (RESLI vs PBO). BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; NA, not applicable; PBO, placebo; RESLI, 3 mg/kg reslizumab. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig 5 ITCs of the change from baseline in prebronchodilator FEV1 (in liters) by baseline blood eosinophil count subgroups and in the ITT population. *P < .05. Comparisons are presented as drug A versus drug B. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. I2 values: 400 cells/μL or greater, 0% (MEPO vs PBO), NA (BENRA vs PBO), and 13% (RESLI vs PBO); 300 cells/μL or greater, 0% (MEPO vs PBO) and 0% (BENRA vs PBO); 150 cells/μL or greater, 0% (MEPO vs PBO) and NA (BENRA vs PBO); unadjusted comparison, 0% (MEPO vs PBO), 0% (BENRA vs PBO), and 13% (RESLI vs PBO). BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; NA, not applicable; PBO, placebo; RESLI, 3 mg/kg reslizumab. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig E1 Treatment comparison with placebo on the rate of clinically significant exacerbations in baseline blood eosinophil count subgroups and the ITT population. **P < .01 and ***P < .001. Comparisons are presented as drug versus placebo. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; PBO, placebo; RESLI, 3 mg/kg reslizumab; SC, subcutaneous. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig E2 Treatment comparison with placebo on the rate of exacerbations requiring ED visits/hospitalizations in baseline blood eosinophil count subgroups and the ITT population. *P < .05, **P < .01, and ***P = .001. Comparisons are presented as drug versus placebo. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; PBO, placebo; RESLI, 3 mg/kg reslizumab; SC, subcutaneous. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig E3 Treatment comparison with placebo on change from baseline in ACQ score in baseline blood eosinophil count subgroups and the ITT population. **P < .01 and ***P < .001. Comparisons are presented as drug versus placebo. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; PBO, placebo; RESLI, 3 mg/kg reslizumab 3; SC, subcutaneous. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions

Fig E4 Treatment comparison with placebo on change from baseline in prebronchodilator FEV1 (liters) in baseline blood eosinophil count subgroups and the ITT population. ***P < .001. Comparisons are presented as drug versus placebo. Not all comparisons were possible at each blood eosinophil count threshold because of a lack of data from included studies. BENRA, Thirty milligrams of benralizumab Q8W; MEPO, 100 mg of mepolizumab administered subcutaneously; PBO, placebo; RESLI, 3 mg/kg reslizumab; SC, subcutaneous. Journal of Allergy and Clinical Immunology 2019 143, 190-200.e20DOI: (10.1016/j.jaci.2018.08.031) Copyright © 2018 GlaxoSmithKline Terms and Conditions