- In patients with uncontrolled asthma despite inhaled corticosteroid (ICS) or ICS plus long-acting beta-agonist (LABA), anti-interleukin (IL)-13 monoclonal antibodies (lebrikizumab and tralokinumab) reduce exacerbations and improve pulmonary function and exacerbation rate.
- Patients with high periostin levels had a lower risk for exacerbations with anti-IL-13 antibodies, but not those with low levels.
Why this matters
- Findings suggest anti-IL-13 monoclonal antibodies could improve the management of uncontrolled asthma.
- Periostin levels can identify patients likely to benefit from anti-IL-13 antibodies.
- Meta-analysis of 5 randomised controlled trials including 3476 patients with poorly controlled asthma despite ICS or ICS+LABA who received anti-IL-13 antibodies, lebrikizumab and tralokinumab.
- Primary outcomes: asthma exacerbation rate, forced expiratory volume in 1 second (FEV1), Asthma Quality of Life Questionnaire (AQLQ) scores, rescue medication use and adverse events.
- Funding: Guangdong Province Natural Science Foundation; High-Level University Construction Project of Guangzhou University of Chinese Medicine and Traditional Chinese Medicine Bureau of Guangdong Province.
- Significant reduction for risk in asthma exacerbation when participants were treated with lebrikizumab or tralokinumab vs placebo (mean difference [MD], −0.19; P<.001>
- Patients with high periostin level (>50 ng/mL) had a lower risk for asthma exacerbation after receiving anti-IL-13 treatment (MD, −0.30; P<.001 but not those with low periostin levels.>
- Heterogeneity between studies.