AUTHOR=Xiong Yu , Hu Jia-qiang , Tang Hui-lin , Zhao Zhi-xia , Liu Li-hong 

TITLE=Network meta-analysis of the efficacy and safety of monoclonal antibodies and traditional conventional dichotomous agents for chronic obstructive pulmonary disease

JOURNAL=Frontiers in Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1334442

DOI=10.3389/fmed.2024.1334442

ISSN=2296-858X

ABSTRACT=To investigate the efficacy and safety of monoclonal antibodies (mAbs) for the treatment of chronic obstructive pulmonary disease (COPD) in terms of improvement in first-second force expiratory volume (FEV1) and the incidence of treatmentemergent adverse events (TEAEs) compared with conventional dichotomous agents. We systematically searched 3 electronic databases (PubMed, EMBASE, and CENTRAL) up to August 1, 2023 to collect eligible randomized controlled trials (RCTs). A frequentist network meta-analysis using a random-effects model was deployed to calculate mean differences (MD) for FEV1, relative risk (RR) of TEAEs, and estimate the surface under cumulative rankings (SUCRA). A higher SUCRA indicates a better outcome. Results: This study included 23 RCTs involving a total of 20,853 patients. Overall, except for Dupilumab, mAbs did not significantly improve FEV1 compared to traditional conventional dichotomous agents. Among all the interventions included, Aclidinium bromide/Formoterol (AB/FF) (SUCRA 97.7 %) ranked highest, followed by Umeclidinium/vilanterol (UMEC/VI) (SUCRA 93.5 %), and Glycopyrrolate Formoterol Fumarate (GFF) (SUCRA 84.7 %). Dupilumab (SUCRA 66.9 %) ranked the fourth among all interventions but ranked the first among all the mAbs. Importantly, all mAbs demonstrated a good safety profile compared with placebo. Considering the improvement in FEV1 and its safety, the development of mAbs for COPD still holds significant clinical potential.