Efficacy and safety of treatment with biologicals (benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab) for severe eosinophilic asthma. A systematic review for the EAACI Guidelines - recommendations on the use of biologicals in severe asthma.


:Five biologicals have been approved for severe eosinophilic asthma, a well-recognized phenotype. Systematic reviews (SR) evaluated the efficacy and safety of benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab (alphabetical order) compared to standard of care for severe eosinophilic asthma. PubMed, Embase and Cochrane Library were searched to identify RCTs and health economic evaluations, published in English. Critical and important asthma-related outcomes were evaluated for each of the biologicals. The risk of bias and the certainty of the evidence were assessed using GRADE. 19 RCTs (three RCTs for benralizumab, three RCTs for dupilumab, three RCTs for mepolizumab, five RCTs for omalizumab and five RCTs for reslizumab), including subjects 12 to 75 years old (except for omalizumab including also subjects 6-11 years old), ranging from 12 to 56 weeks were evaluated. All biologicals reduce exacerbation rates with high certainty of evidence: benralizumab incidence rate ratio (IRR) 0.53 (95% CI 0.39 to 0.72), dupilumab (IRR) 0.43 (95% CI 0.32 to 0.59), mepolizumab IRR 0.49 (95% CI 0.38 to 0.66), omalizumab (IRR) 0.56 (95% CI 0.40 to 0.77) and reslizumab (IRR) 0.46 (95% CI 0.37 to 0.58). Benralizumab, dupilumab and mepolizumab reduce the daily dose of oral corticosteroids (OCS) with high certainty of evidence. All evaluated biologicals probably improve asthma control, QoL and FEV1 , without reaching the minimal important difference (moderate certainty). Benralizumab, mepolizumab and reslizumab slightly increase drug-related adverse events (AE) and drug-related serious AE (low to very low certainty of evidence). The incremental cost-effectiveness ratio per quality-adjusted life year value is above the willingness to pay threshold for all biologicals (moderate certainty). Potential savings are driven by decrease in hospitalizations, emergency and primary care visits. There is high certainty that all approved biologicals reduce the rate of severe asthma exacerbations and for benralizumab, dupilumab and mepolizumab for reducing OCS. There is moderate certainty for improving asthma control, QoL, FEV1 . More data on long-term safety are needed together with more efficacy data in the paediatric population.






Agache I,Beltran J,Akdis C,Akdis M,Canelo-Aybar C,Canonica GW,Casale T,Chivato T,Corren J,Del Giacco S,Eiwegger T,Firinu D,Gern JE,Hamelmann E,Hanania N,Mäkelä M,Hernández-Martín I,Nair P,O'Mahony L,Papadopoulos NG




Has Abstract


2020-05-01 00:00:00














  • Safety, efficacy and repeatability of a novel house dust mite allergen challenge technique in the Fraunhofer allergen challenge chamber.

    abstract:BACKGROUND:Efficacy testing of immunotherapy in field studies is often hampered by variation of airborne allergens. Standardized allergen exposure in challenge chamber settings might be an alternative. Therefore, we developed a universal technique to create an atmosphere loaded with allergen particles of adjustable siz...


    pub_type: 杂志文章


    authors: Lueer K,Biller H,Casper A,Windt H,Mueller M,Badorrek P,Haefner D,Framke T,Koch A,Ziehr H,Krug N,Koch W,Hohlfeld JM

    更新日期:2016-12-01 00:00:00

  • Genetic and environmental factors in the changing incidence of allergy.

    abstract::Several studies have indicated that the incidence and prevalence of allergic diseases are increasing. Such data should not be regarded as mere statistical curiosities, but should be analysed to provide information on the factors contributing to allergy and its changing epidemiology. Extensive evidence has been accumul...


    pub_type: 杂志文章


    authors: Bonini S,Magrini L,Rotiroti G,Ronchetti MP,Onorati P

    更新日期:1994-01-01 00:00:00

  • Lowered glutathione-peroxidase activity in asthmatic patients with food and aspirin intolerance.

    abstract::In analogy with findings from animal experiments, people with low glutathione-peroxidase (GSH-Px) activity could be expected to have altered sensitivities to effects of drugs, chemicals and possibly food. We have investigated GSH-Px activity in 12 patients with intrinsic asthma and food and aspirin intolerance. Ten of...


    pub_type: 杂志文章


    authors: Malmgren R,Unge G,Zetterström O,Theorell H,de Wahl K

    更新日期:1986-01-01 00:00:00

  • Filaggrin mutations in the onset of eczema, sensitization, asthma, hay fever and the interaction with cat exposure.

    abstract:BACKGROUND:Filaggrin gene (FLG) mutations contribute to the development of eczema and asthma, but their contribution to sensitization and hay fever remains unclear. METHODS:FLG mutations R501X, 2282del4 and R2447X were genotyped in the Prevention and Incidence of Asthma and Mite Allergy birth cohort (n = 934) to evalu...


    pub_type: 杂志文章


    authors: Schuttelaar ML,Kerkhof M,Jonkman MF,Koppelman GH,Brunekreef B,de Jongste JC,Wijga A,McLean WH,Postma DS

    更新日期:2009-12-01 00:00:00

  • Chaperone patterns in vernal keratoconjunctivitis are distinctive of cell and Hsp type and are modified by inflammatory stimuli.

    abstract:BACKGROUND:Vernal keratoconjunctivitis (VKC) is a severe ocular allergy with pathogenic mechanism poorly understood and no efficacious treatment. The aims of the study were to determine quantities and distribution of Hsp chaperones in the conjunctiva of VKC patients and assess their levels in conjunctival epithelial an...


    pub_type: 杂志文章


    authors: Leonardi A,Tarricone E,Corrao S,Alaibac M,Corso AJ,Zavan B,Venier P,Conway de Macario E,Macario AJ,Di Stefano A,Cappello F,Brun P

    更新日期:2016-03-01 00:00:00

  • Antiallergic drugs and the immune response. Interactions and possible clinical relevance.

    abstract::Since the pharmacological treatment of allergic diseases is used in patients with alteration of the immune response due to atopy and possible concomitant infections, we have investigated the possible effects of such drugs as cromolyn, theophylline, ketotifen, oxatomide, astemizole, fenoterol, pirenzepine, and rosapros...


    pub_type: 杂志文章,评审


    authors: Canonica GW,Ciprandi G

    更新日期:1989-01-01 00:00:00

  • Double-blind, placebo-controlled, dose-ranging study of new recombinant hypoallergenic Bet v 1 in an environmental exposure chamber.

    abstract:BACKGROUND:Recombinant allergens offer a tool for improving specific immunotherapy (SIT). OBJECTIVE:To find the optimal dose of a new hypoallergenic folding variant of recombinant Bet v 1 (rBet v 1-FV) as SIT for patients with birch pollen allergy. METHODS:Before SIT, thirty-seven adult patients were exposed for eigh...


    pub_type: 杂志文章,随机对照试验


    authors: Meyer W,Narkus A,Salapatek AM,Häfner D

    更新日期:2013-06-01 00:00:00

  • Markers of autoreactivity, coagulation and angiogenesis in patients with nonallergic asthma.

    abstract:BACKGROUND:Patients with nonallergic asthma frequently show autoreactivity as do subjects with chronic urticaria (CU). Activation of the coagulation cascade and hyper-expression of vascular endothelial growth factor (VEGF) were recently found in CU, and there is sparse evidence that the same may occur in asthma. OBJEC...


    pub_type: 杂志文章


    authors: Asero R,Tedeschi A,Cugno M

    更新日期:2011-10-01 00:00:00

  • Is the hygiene hypothesis still a viable explanation for the increased prevalence of asthma?

    abstract::The hygiene hypothesis states that a reduced exposure to allergens in early life is solely implicated in the growing propensity for allergy sensitization. Important elements of the hypothesis include helminth infection, exposure to endotoxins, exposure to pets and growing up on a farm. However, the hygiene hypothesis ...


    pub_type: 杂志文章,评审


    authors: Platts-Mills TA,Erwin E,Heymann P,Woodfolk J

    更新日期:2005-01-01 00:00:00

  • Rhinitis symptoms and IgE sensitization as risk factors for development of later allergic rhinitis in adults.

    abstract:BACKGROUND:Rhinitis symptoms and IgE-sensitization often mismatch. Asymptomatic sensitization is an established risk factor for later rhinitis, whereas it is not clear whether rhinitis is a risk factor for later development of IgE-sensitization. OBJECTIVE:To investigate whether nonallergic rhinitis is a risk factor fo...


    pub_type: 杂志文章


    authors: Bodtger U,Poulsen LK,Linneberg A

    更新日期:2006-06-01 00:00:00

  • Olive allergen-specific IgE responses in patients with Olea europaea pollinosis.

    abstract:BACKGROUND:Olive tree (Olea europaea) pollen is an important cause of pollinosis in the countries of the Mediterranean area. OBJECTIVE:This work aimed to study the IgE-binding frequency of Ole e 1, Ole e 2, Ole e 3, Ole e 6 and Ole e 7 from O. europaea pollen in a large population of olive pollen-allergic patients. M...


    pub_type: 杂志文章


    authors: Quiralte J,Florido F,Arias de Saavedra JM,Gómez A,Sáenz de San Pedro B,González E,Rodríguez R

    更新日期:2002-01-01 00:00:00

  • Nasal and exhaled nitric oxide in response to occupational latex exposure.

    abstract:BACKGROUND:Latex sensitivity is an increasing problem among health-care workers. Allergic responses are associated with changes in nitric oxide (NO) generation and the changes secondary to latex have not been described. METHODS:A total of 22 subjects comprising equal numbers of control volunteers and subjects with sel...


    pub_type: 杂志文章


    authors: Tan K,Bruce C,Birkhead A,Thomas PS

    更新日期:2001-07-01 00:00:00

  • Safety and reproducibility of nasal allergen challenge.

    abstract:BACKGROUND:The nasal allergen challenge (NAC) is a useful tool for the diagnosis of allergic rhinitis (AR) and local allergic rhinitis (LAR) and might serve to design and monitor allergen immunotherapy. Nevertheless, data about its safety and reproducibility are scarce. OBJECTIVE:To investigate the safety and reproduc...


    pub_type: 杂志文章


    authors: Eguiluz-Gracia I,Testera-Montes A,González M,Pérez-Sánchez N,Ariza A,Salas M,Moreno-Aguilar C,Campo P,Torres MJ,Rondon C

    更新日期:2019-06-01 00:00:00

  • Glucocorticoid-induced attenuation of mucosal exudation of fibrinogen and bradykinins in seasonal allergic rhinitis.

    abstract::The mucosal plasma exudate with its proteins, enzymes, derived peptides, and matrix molecules is an important factor in inflammatory airway diseases. This study investigated whether topical glucocorticosteroid treatment influences mucosal exudation of bulk plasma (fibrinogen) and the generation of plasma-derived media...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Svensson C,Klementsson H,Andersson M,Pipkorn U,Alkner U,Persson CG

    更新日期:1994-03-01 00:00:00

  • Eosinophilic gastroenteritis and Anisakis.

    abstract:BACKGROUND:The differential diagnosis of eosinophilic gastroenteritis (EG) includes, among other diseases, parasitic infections such as anisakiasis, which has acquired worldwide importance. METHODS:We reviewed all patients referred to our allergy service who had been diagnosed as having primary EG to determine the pos...


    pub_type: 杂志文章


    authors: Gómez B,Tabar AI,Tuñón T,Larrínaga B,Alvarez MJ,García BE,Olaguibel JM

    更新日期:1998-12-01 00:00:00

  • Gene expression analysis predicts insect venom anaphylaxis in indolent systemic mastocytosis.

    abstract:BACKGROUND:Anaphylaxis to insect venom (Hymenoptera) is most severe in patients with mastocytosis and may even lead to death. However, not all patients with mastocytosis suffer from anaphylaxis. The aim of the study was to analyze differences in gene expression between patients with indolent systemic mastocytosis (ISM)...


    pub_type: 杂志文章


    authors: Niedoszytko M,Bruinenberg M,van Doormaal JJ,de Monchy JG,Nedoszytko B,Koppelman GH,Nawijn MC,Wijmenga C,Jassem E,Elberink JN

    更新日期:2011-05-01 00:00:00

  • Mast cell activation syndromes: definition and classification.

    abstract::Mast cell activation (MCA) occurs in a number of different clinical conditions, including IgE-dependent allergies, other inflammatory reactions, and mastocytosis. MCA-related symptoms may be mild, moderate, severe, or even life-threatening. The severity of MCA depends on a number of different factors, including geneti...


    pub_type: 杂志文章,评审


    authors: Valent P

    更新日期:2013-04-01 00:00:00

  • Specific interaction of IgE antibodies with a carbohydrate epitope of honey bee venom phospholipase A2.

    abstract::Phospholipase A2 (E.C. is a major allergen of honey bee venom. It exists in a glycosylated and an unglycosylated variant. Both forms and the glycopeptide isolated after exhaustive proteolytic digestion were tested in RAST and RAST inhibition studies. IgE from 11 of 14 bee venom allergy sera exhibited signifi...


    pub_type: 杂志文章


    authors: Weber A,Schröder H,Thalberg K,März L

    更新日期:1987-08-01 00:00:00

  • IgE concentrations measured by PRIST in serum of healthy adults and in patients with respiratory allergy. A diagnostic approach.

    abstract::In order to establish reference values for total serum IgE in an adult non-atopic population, 175 individuals, 17-85 years of age, were investigated. The usefulness of a sensitive method (PRIST) for serum IgE determinations in discriminating atopy from non-atopic conditions in allergological routine diagnosis was eluc...


    pub_type: 杂志文章


    authors: Zetterström O,Johansson SG

    更新日期:1981-11-01 00:00:00

  • Ingestive and inhalative allergy to the mushroom Boletus edulis.

    abstract::This is the first report on inhalative and ingestive allergy to the common edible mushroom Boletus edulis (Be) (English, edible boletus; German, Steinpilz; French, bolet; Italian, porcino or boleto) belonging to the class Basidiomycetes. Four cases observed in our allergy unit are presented, showing different clinical...


    pub_type: 杂志文章


    authors: Torricelli R,Johansson SG,Wüthrich B

    更新日期:1997-07-01 00:00:00

  • Common characteristics of upper and lower airways in rhinitis and asthma: ARIA update, in collaboration with GA(2)LEN.

    abstract::This update aimed to review the new evidence available to support or refute prior Allergic Rhinitis and its Impact on Asthma (ARIA) statements. A Medline search of publications between 2000 and 2005 was conducted, with articles selected by experts. New evidence supports previous ARIA statements, such as: (i) allergic ...


    pub_type: 杂志文章,评审


    authors: Cruz AA,Popov T,Pawankar R,Annesi-Maesano I,Fokkens W,Kemp J,Ohta K,Price D,Bousquet J,ARIA Initiative Scientific Committee.

    更新日期:2007-01-01 00:00:00

  • The effect of antiallergic intranasal formulations on ciliary beat frequency of human nasal epithelium in vitro.

    abstract::The nasal mucociliary clearance is an important defense mechanism of the upper respiratory tract. It is known to be influenced by many pharmacologic substances. We investigated the effects of three topical intranasal antiallergic formulations containing disodium cromoglycate (DNCG), dimethindene maleate (DMM), and aze...


    pub_type: 杂志文章


    authors: Alberty J,Stoll W

    更新日期:1998-10-01 00:00:00

  • Monocytes enhance neutrophil-induced blister formation in an ex vivo model of bullous pemphigoid.

    abstract:BACKGROUND:Lesions of bullous pemphigoid (BP), an autoimmune subepidermal blistering disease characterized by the presence of tissue-bound and circulating autoantibodies to hemidesmosomal antigens, harbor a mixed inflammatory cellular infiltrate. In various models, neutrophils, eosinophils, mast cells, monocytes as wel...


    pub_type: 杂志文章


    authors: de Graauw E,Sitaru C,Horn MP,Borradori L,Yousefi S,Simon D,Simon HU

    更新日期:2018-05-01 00:00:00

  • Screening for IgE-mediated allergy.

    abstract::Sera from 425 patients were analysed with Phadebas RAST reagents against a panel of 19 allergens and the most commonly positive results were to grass pollen, Dermatophagoides pteronyssinus and cat epithelium. Of the 275 sera RAST-positive to any allergen, 261 were positive by a RAST technique which used a mixture of t...


    pub_type: 杂志文章


    authors: Merrett TG,Pantin CF,Dimond AH,Merrett J

    更新日期:1980-09-01 00:00:00

  • Sustained effect of SQ-standardized grass allergy immunotherapy tablet on rhinoconjunctivitis quality of life.

    abstract:BACKGROUND:The prevalence of allergic rhinoconjunctivitis has increased significantly over the past decades with grass pollen being a common trigger. The impact of allergy on patient's quality of life is substantial. AIM:To investigate the sustained effect on quality of life during the grass pollen season 1 year after...


    pub_type: 杂志文章,随机对照试验


    authors: Frølund L,Durham SR,Calderon M,Emminger W,Andersen JS,Rask P,Dahl R

    更新日期:2010-06-01 00:00:00

  • Staphylococcus aureus from atopic dermatitis skin accumulates in the lysosomes of keratinocytes with induction of IL-1α secretion via TLR9.

    abstract:BACKGROUND:Staphylococcus aureus (S. aureus) is frequently detected in the skin of patients with atopic dermatitis (AD), and involved in the flare of AD. There are some evidence-specific strains of S. aureus affect the severity of AD. However, the mechanism of predominant colonization and the aggravation of dermatitis ...


    pub_type: 杂志文章


    authors: Moriwaki M,Iwamoto K,Niitsu Y,Matsushima A,Yanase Y,Hisatsune J,Sugai M,Hide M

    更新日期:2019-03-01 00:00:00

  • Sensitization to local dust-mite fauna in Singapore.

    abstract:BACKGROUND:Recent studies showed the presence of a unique dust-mite fauna in the indoor environment of Singapore. Immediate hypersensitivity to these dust mites, along with other known indoor allergens, may play a role in the pathogenesis of allergic respiratory diseases. This study evaluated the sensitization rates of...


    pub_type: 杂志文章


    authors: Chew FT,Lim SH,Goh DY,Lee BW

    更新日期:1999-11-01 00:00:00

  • Comorbid "treatable traits" in difficult asthma: Current evidence and clinical evaluation.

    abstract::The care of patients with difficult-to-control asthma ("difficult asthma") is challenging and costly. Despite high-intensity asthma treatment, these patients experience poor asthma control and face the greatest risk of asthma morbidity and mortality. Poor asthma control is often driven by severe asthma biology, which ...


    pub_type: 杂志文章,评审


    authors: Tay TR,Hew M

    更新日期:2018-07-01 00:00:00

  • Existence of exine-free airborne allergen particles of Japanese cedar (Cryptomeria japonica) pollen.

    abstract::We investigated whether exine-free pollen allergen particles exist together with the intact pollen grains of Japanese cedar (Cryptomeria japonica) in the air during the pollen season in Yamagata City. First, we separated the allergen particles in an Andersen multi-stage air-sampler according to their aerodynamic diame...


    pub_type: 杂志文章


    authors: Takahashi Y,Sakaguchi M,Inouye S,Miyazawa H,Imaoka K,Katagiri S

    更新日期:1991-11-01 00:00:00

  • Paving the way of systems biology and precision medicine in allergic diseases: the MeDALL success story: Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015.

    abstract::MeDALL (Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015) has proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy. MeDALL has linked epidemiological, clinical and basic research using a stepwise, large-scale ...


    pub_type: 杂志文章,评审


    authors: Bousquet J,Anto JM,Akdis M,Auffray C,Keil T,Momas I,Postma DS,Valenta R,Wickman M,Cambon-Thomsen A,Haahtela T,Lambrecht BN,Lodrup Carlsen KC,Koppelman GH,Sunyer J,Zuberbier T,Annesi-Maesano I,Arno A,Bindslev-Jensen C

    更新日期:2016-11-01 00:00:00