Efficacy and safety of dupilumab for the treatment of uncontrolled asthma: a meta-analysis of randomized clinical trials

BACKGROUND: Several recent clinical trials have assessed the effects of dupilumab in uncontrolled asthma, but reached no definite conclusion. We therefore conducted this meta-analysis to evaluate the overall efficacy and safety of dupilumab for the treatment of uncontrolled asthma. METHODS: All randomized controlled trials were included. Standard mean differences (SMD) or relative risks (RR) were calculated using Fixed-or random-effects models. RESULTS: Five studies involving 3369 patients were identified. Pooled analysis showed significant improvements in the first-second forced expiratory volume (FEV(1)) (SMD = 4.29, 95% CI: 2.78–5.81) and Asthma Quality of Life Questionnaire scores (SMD = 4.39, 95% CI: 1.44–7.34). Dupilumab treatments were also associated with significantly decreased 5-item Asthma Control Questionnaire scores (SMD = − 4.95, 95% CI: − 7.30 to − 2.60), AM and PM asthma symptom scores (SMD = − 5.09, 95% CI: − 6.40 to − 3.77; SMD = − 4.92, 95% CI: − 5.98 to − 3.86, respectively), and severe exacerbation risk (RR = 0.73; 95% CI: 0.67–0.79) compared with placebo, with similar incidence of adverse events (RR = 1.0; 95% CI: 0.96–1.04). CONCLUSION: Dupilumab treatment is relatively well-tolerated and could significantly improve FEV(1), symptoms, asthma control, and quality of life, and reduced severe exacerbation risk in patients with uncontrolled asthma.