Benralizumab for the Prevention of COPD Exacerbations

The efficacy and safety of benralizumab, an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody, for the prevention of exacerbations in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) are not known.In the GALATHEA and TERRANOVA trials, we enrolled p...

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Elmentve itt :
Bibliográfiai részletek
Szerzők: Criner Gerard J
Celli Bartolome R
Brightling Christopher E
Agusti Alvar
Papi Alberto
Singh Dave
Sin Don D
Vogelmeier Claus F
Sciurba Frank C
Bafadhel Mona
Backer Vibeke
Kato Motokazu
Ramírez-Venegas Alejandra
Wei Yu-Feng
Bjermer Leif
Shih Vivian H
Jison Maria
O'Quinn Sean
Makulova Natalya
Newbold Paul
Goldman Mitchell
Martin Ubaldo J
Kollaborációs szervezet: GALATHEA Study Investigators
Kollaborációs szervezet: TERRANOVA Study Investigators
Bálint Beatrix
Dokumentumtípus: Cikk
Megjelent: 2019
Sorozat:NEW ENGLAND JOURNAL OF MEDICINE 381 No. 11
Tárgyszavak:
doi:10.1056/NEJMoa1905248

mtmt:31168405
Online Access:http://publicatio.bibl.u-szeged.hu/29946
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520 3 |a The efficacy and safety of benralizumab, an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody, for the prevention of exacerbations in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) are not known.In the GALATHEA and TERRANOVA trials, we enrolled patients with COPD (at a ratio of approximately 2:1 on the basis of eosinophil count [≥220 per cubic millimeter vs. <220 per cubic millimeter]) who had frequent exacerbations despite receiving guideline-based inhaled treatment. Patients were randomly assigned to receive benralizumab (30 or 100 mg in GALATHEA; 10, 30, or 100 mg in TERRANOVA) every 8 weeks (every 4 weeks for the first three doses) or placebo. The primary end point was the treatment effect of benralizumab, measured as the annualized COPD exacerbation rate ratio (benralizumab vs. placebo) at week 56 in patients with baseline blood eosinophil counts of 220 per cubic millimeter or greater. Safety was also assessed.In GALATHEA, the estimates of the annualized exacerbation rate were 1.19 per year (95% confidence interval [CI], 1.04 to 1.36) in the 30-mg benralizumab group, 1.03 per year (95% CI, 0.90 to 1.19) in the 100-mg benralizumab group, and 1.24 per year (95% CI, 1.08 to 1.42) in the placebo group; the rate ratio as compared with placebo was 0.96 for 30 mg of benralizumab (P = 0.65) and 0.83 for 100 mg of benralizumab (P = 0.05). In TERRANOVA, the estimates of the annualized exacerbation rate for 10 mg, 30 mg, and 100 mg of benralizumab and for placebo were 0.99 per year (95% CI, 0.87 to 1.13), 1.21 per year (95% CI, 1.08 to 1.37), 1.09 per year (95% CI, 0.96 to 1.23), and 1.17 per year (95% CI, 1.04 to 1.32), respectively; the corresponding rate ratios were 0.85 (P = 0.06), 1.04 (P = 0.66), and 0.93 (P = 0.40). At 56 weeks, none of the annualized COPD exacerbation rate ratios for any dose of benralizumab as compared with placebo reached significance in either trial. Types and frequencies of adverse events were similar with benralizumab and placebo.Add-on benralizumab was not associated with a lower annualized rate of COPD exacerbations than placebo among patients with moderate to very severe COPD, a history of frequent moderate or severe exacerbations, and blood eosinophil counts of 220 per cubic millimeter or greater (Funded by AstraZeneca [GALATHEA and TERRANOVA] and Kyowa Hakko Kirin [GALATHEA]; GALATHEA and TERRANOVA ClinicalTrials.gov numbers, NCT02138916 and NCT02155660.). 
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700 0 1 |a Celli Bartolome R  |e aut 
700 0 1 |a Brightling Christopher E  |e aut 
700 0 1 |a Agusti Alvar  |e aut 
700 0 1 |a Papi Alberto  |e aut 
700 0 1 |a Singh Dave  |e aut 
700 0 1 |a Sin Don D  |e aut 
700 0 1 |a Vogelmeier Claus F  |e aut 
700 0 1 |a Sciurba Frank C  |e aut 
700 0 1 |a Bafadhel Mona  |e aut 
700 0 1 |a Backer Vibeke  |e aut 
700 0 1 |a Kato Motokazu  |e aut 
700 0 2 |a Ramírez-Venegas Alejandra  |e aut 
700 0 2 |a Wei Yu-Feng  |e aut 
700 0 2 |a Bjermer Leif  |e aut 
700 0 2 |a Shih Vivian H  |e aut 
700 0 2 |a Jison Maria  |e aut 
700 0 2 |a O'Quinn Sean  |e aut 
700 0 2 |a Makulova Natalya  |e aut 
700 0 2 |a Newbold Paul  |e aut 
700 0 2 |a Goldman Mitchell  |e aut 
700 0 2 |a Martin Ubaldo J  |e aut 
700 0 2 |a Kollaborációs szervezet: GALATHEA Study Investigators  |e aut 
700 0 2 |a Kollaborációs szervezet: TERRANOVA Study Investigators  |e aut 
700 0 2 |a Bálint Beatrix  |e aut 
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