Type 2 Inflammation-Specific Agents Ease Asthma Exacerbations

Type 2 inflammation-specific agents that target interleukins are significantly associated with a reduced rate of asthma exacerbations in patients with severe asthma, according to findings from a systematic review and meta-analysis published in the Yonsei Medical Journal.

“The rate ratio for the number of annual asthma exacerbations showed that the type 2-specific agents had a favorable effect compared with placebo (RR 0.58, 95% CI 0.51 to 0.66), which can be translated into an absolute risk reduction of 42%,” wrote a research team based in Korea. “These findings support the clinical efficacy of type 2-specific agents in the treatment of severe asthma.”

The analysis spanned 11,800 participants from 17 studies. Nearly 6200 patients received type 2-specific agents, namely benralizumab, dupilumab, lebrikizumab, mepolizumab, reslizumab, and tralokinumab.

In addition to a 48% absolute risk reduction with type 2-specific agents overall, pooled estimates for the individual agents benralizumab, dupilumab, lebrikizumab, mepolizumab, and reslizumab showed considerable effectiveness in reducing the annual asthma exacerbation rate, according to the study. Only tralokinumab failed to lower asthma exacerbation risk.

Furthermore, a subgroup analysis showed that type 2-specific agents reduced the risk of asthma exacerbations in patients with eosinophil counts of ≥300 cells/µL even further: researchers reported a rate ratio of 0.41. The rate ratio for patients with eosinophil counts of <300 cells/µL, meanwhile, was 0.67.

“Our findings are consistent with the statements of current guidelines, and type 2-specific agents can be considered as add-on therapy for severe asthma patients,” researchers wrote.

Reference:
Lee J, Song JU, Kim YH. The clinical efficacy of type 2 inflammation-specific agents targeting interleukins in reducing exacerbations in severe asthma: a meta-analysis. Yonsei Med J. 2022;63(6):511-519. doi:10.3349/ymj.2022.63.6.511