度普利尤单抗对比美泊利单抗与贝那利珠单抗治疗哮喘的有效性研究：一项多国回顾性队列分析
2025/04/30
摘要
背景：目前已有多种生物制剂获批用于哮喘治疗。但既往比较有效性研究多为间接治疗对比或受限于地域范围。
目的：比较度普利尤单抗与美泊利单抗、贝那利珠单抗在降低哮喘患者急性发作方面的疗效差异。
方法：本研究采用TriNetX全球协作网络数据，纳入2018年11月1日至2024年1月1日期间接受度普利尤单抗、美泊利单抗、贝那利珠单抗治疗的≥18岁哮喘患者。主要结局指标为一年随访期内首次哮喘急性发作时间。进行两组对比：(1) 度普利尤单抗对比美泊利单抗；(2) 度普利尤单抗对比贝那利珠单抗。采用倾向评分匹配平衡组间协变量，通过Kaplan-Meier曲线和Cox比例风险模型评估急性发作风险。根据嗜酸性粒细胞计数（≥300、≥150-<300及<150个/μL）、慢性阻塞性肺疾病（COPD）共病情况及急性发作史（0次与≥1次）进行亚组分析。
结果: 与美泊利单抗相比（HR=0.68，95%CI：0.62-0.76），度普利尤单抗可显著降低哮喘急性发作风险；与贝那利珠单抗相比（HR=0.74，95%CI：0.67-0.82）同样具有优势。在嗜酸性粒细胞≥300个/μL、合并COPD以及无急性发作史的患者中，度普利尤单抗的临床获益尤为显著。
结论：在哮喘患者中，度普利尤单抗较美泊利单抗和贝那利珠单抗更能有效降低急性发作风险。未来需结合更全面的生物标志物数据进一步研究，以优化生物制剂的选择策略。
Comparative effectiveness of dupilumab versus mepolizumab and benralizumab in asthma: a multinational retrospective cohort study.
Chun-Tse, Hung; Yu-Chien, Hung; Chi-Won, Suk
Abstrast
Background: Several biologic agents have been approved for asthma treatment. However, previous comparative effectiveness studies have been indirect treatment comparisons or restricted in geographical scope.
Objective: To compare the effectiveness of dupilumab versus mepolizumab and benralizumab in reducing asthma exacerbations among patients with asthma.
Methods: Data from the Global Collaborative Network of TriNetX were used. Patients aged ≥18 years who received dupilumab, mepolizumab or benralizumab for asthma between November 1, 2018, and January 1, 2024, were included. The primary outcome was time to the first asthma exacerbation within the one-year follow-up period. Two comparisons were performed: (1) dupilumab versus mepolizumab and (2) dupilumab versus benralizumab. Propensity score matching was used to balance covariates between groups. The risk of asthma exacerbations was estimated using Kaplan-Meier curves and Cox proportional hazards models. Subgroup analyses were conducted based on eosinophil counts (≥300, ≥150-<300, and <150 cells/μL), the presence of chronic obstructive pulmonary disease (COPD), and exacerbation history (0 and ≥1 events).
Results: Dupilumab was associated with a lower risk of asthma exacerbations compared to mepolizumab (HR, 0.68; 95% CI, 0.62-0.76) and benralizumab (HR, 0.74; 95% CI, 0.67-0.82). Benefits of dupilumab were pronounced in patients with eosinophil counts ≥300 cells/μL, those with COPD, and those without an exacerbation history.
Conclusion: Dupilumab was associated with a decreased risk of asthma exacerbations compared to both mepolizumab and benralizumab among patients with asthma. Further research incorporating comprehensive biomarker data is needed to optimize biologic selection.
背景：目前已有多种生物制剂获批用于哮喘治疗。但既往比较有效性研究多为间接治疗对比或受限于地域范围。
目的：比较度普利尤单抗与美泊利单抗、贝那利珠单抗在降低哮喘患者急性发作方面的疗效差异。
方法：本研究采用TriNetX全球协作网络数据，纳入2018年11月1日至2024年1月1日期间接受度普利尤单抗、美泊利单抗、贝那利珠单抗治疗的≥18岁哮喘患者。主要结局指标为一年随访期内首次哮喘急性发作时间。进行两组对比：(1) 度普利尤单抗对比美泊利单抗；(2) 度普利尤单抗对比贝那利珠单抗。采用倾向评分匹配平衡组间协变量，通过Kaplan-Meier曲线和Cox比例风险模型评估急性发作风险。根据嗜酸性粒细胞计数（≥300、≥150-<300及<150个/μL）、慢性阻塞性肺疾病（COPD）共病情况及急性发作史（0次与≥1次）进行亚组分析。
结果: 与美泊利单抗相比（HR=0.68，95%CI：0.62-0.76），度普利尤单抗可显著降低哮喘急性发作风险；与贝那利珠单抗相比（HR=0.74，95%CI：0.67-0.82）同样具有优势。在嗜酸性粒细胞≥300个/μL、合并COPD以及无急性发作史的患者中，度普利尤单抗的临床获益尤为显著。
结论：在哮喘患者中，度普利尤单抗较美泊利单抗和贝那利珠单抗更能有效降低急性发作风险。未来需结合更全面的生物标志物数据进一步研究，以优化生物制剂的选择策略。
（中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校）
（J Allergy Clin Immunol Pract 2025 Apr 16;0(0)；DOI: 10.1016/j.jaip.2025.04.015.IF: 7.574）
Comparative effectiveness of dupilumab versus mepolizumab and benralizumab in asthma: a multinational retrospective cohort study.
Chun-Tse, Hung; Yu-Chien, Hung; Chi-Won, Suk
Abstrast
Background: Several biologic agents have been approved for asthma treatment. However, previous comparative effectiveness studies have been indirect treatment comparisons or restricted in geographical scope.
Objective: To compare the effectiveness of dupilumab versus mepolizumab and benralizumab in reducing asthma exacerbations among patients with asthma.
Methods: Data from the Global Collaborative Network of TriNetX were used. Patients aged ≥18 years who received dupilumab, mepolizumab or benralizumab for asthma between November 1, 2018, and January 1, 2024, were included. The primary outcome was time to the first asthma exacerbation within the one-year follow-up period. Two comparisons were performed: (1) dupilumab versus mepolizumab and (2) dupilumab versus benralizumab. Propensity score matching was used to balance covariates between groups. The risk of asthma exacerbations was estimated using Kaplan-Meier curves and Cox proportional hazards models. Subgroup analyses were conducted based on eosinophil counts (≥300, ≥150-<300, and <150 cells/μL), the presence of chronic obstructive pulmonary disease (COPD), and exacerbation history (0 and ≥1 events).
Results: Dupilumab was associated with a lower risk of asthma exacerbations compared to mepolizumab (HR, 0.68; 95% CI, 0.62-0.76) and benralizumab (HR, 0.74; 95% CI, 0.67-0.82). Benefits of dupilumab were pronounced in patients with eosinophil counts ≥300 cells/μL, those with COPD, and those without an exacerbation history.
Conclusion: Dupilumab was associated with a decreased risk of asthma exacerbations compared to both mepolizumab and benralizumab among patients with asthma. Further research incorporating comprehensive biomarker data is needed to optimize biologic selection.
上一篇：
没有了
下一篇：
没有了
