title: Meta-analysis of asthma-related hospitalization in mepolizumab studies of severe eosinophilic asthma.
abstract: BACKGROUND
  Studies show that mepolizumab can reduce the frequency of clinically significant exacerbations in patients with severe eosinophilic asthma, compared with placebo. However, important events such as hospitalizations and emergency room visits are rare and difficult to characterize in single studies.
  
  
  OBJECTIVE
  We sought to compare hospitalization or hospitalization and/or emergency room visit rates in patients with severe eosinophilic asthma treated with mepolizumab or placebo in addition to standard of care for at least 24 weeks.
  
  
  METHODS
  This study was conducted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. PubMed and the GSK Clinical Study Register were searched for suitable studies. The primary end points were the rate of exacerbations requiring hospitalization and the rate of exacerbations requiring hospitalization/emergency room visit. The proportion of patients with 1 or more event was also assessed. All mepolizumab doses were combined and individual patient-level data were analyzed.
  
  
  RESULTS
  Four studies (n = 1388) were eligible for inclusion. Mepolizumab significantly reduced the rate of exacerbations requiring hospitalization (relative rate, 0.49; 95% CI, 0.30-0.80; P = .004) and hospitalization/emergency room visit (relative rate, 0.49; 95% CI, 0.33-0.73; P < .001) versus placebo. Significant reductions of 45% and 38% were also observed for the proportion of patients experiencing 1 or more hospitalization and hospitalization and/or emergency room visit, respectively.
  
  
  CONCLUSIONS
  Mepolizumab approximately halved exacerbations requiring hospitalization and/or emergency room visits compared with placebo in patients with severe eosinophilic asthma. This treatment addresses a key outcome in a patient population with a high unmet need (GSK Study 204664).
authors.affiliation: Respiratory Therapeutic Area, GSK, Research Triangle Park, NC. Electronic address: steve.w.yancey@gsk.com.
authors.forename: Steven W
authors.initials: SW
authors.lastname: Yancey
authors.affiliation: Respiratory Therapeutic Area, GSK, Research Triangle Park, NC.
authors.forename: Hector G
authors.initials: HG
authors.lastname: Ortega
authors.affiliation: Clinical Statistics, GSK, Stockley Park, Uxbridge, United Kingdom.
authors.forename: Oliver N
authors.initials: ON
authors.lastname: Keene
authors.affiliation: Clinical Statistics, GSK, Stockley Park, Uxbridge, United Kingdom.
authors.forename: Bhabita
authors.initials: B
authors.lastname: Mayer
authors.affiliation: Clinical Statistics, GSK, Stockley Park, Uxbridge, United Kingdom.
authors.forename: Necdet B
authors.initials: NB
authors.lastname: Gunsoy
authors.affiliation: Institute for Lung Health, University of Leicester, Leicester, United Kingdom.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Brightling
authors.affiliation: Center for Genomics and Personalized Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Bleecker
authors.affiliation: Institute for Lung Health, University of Leicester, Leicester, United Kingdom.
authors.forename: Pranabashis
authors.initials: P
authors.lastname: Haldar
authors.affiliation: Respiratory Medicine Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Pavord
mesh_terms: D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000473:pathology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D011657:Pulmonary Eosinophilia / Q000188:drug therapy*
chemical_list: D018927:Anti-Asthmatic Agents; D061067:Antibodies, Monoclonal, Humanized; C434107:mepolizumab
keywords: Antiasthmatic agents; IL-5; emergency service; exacerbation; hospital; mepolizumab; meta-analysis; severe eosinophilic asthma