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 (FEV1) (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 FEV1, symptoms, asthma control, and quality of life, and reduced severe exacerbation risk in patients with uncontrolled asthma.