%0 Journal Article %A Arnaud Bourdin %A Don Husereau %A Nicolas Molinari %A Sarowar Golam %A Mohd Kashif Siddiqui %A Leandro Lindner %A Xiao Xu %T Matching-Adjusted Indirect Comparison of Benralizumab versus Interleukin-5 Inhibitors: Systematic Review %D 2018 %R 10.1183/13993003.01393-2018 %J European Respiratory Journal %P 1801393 %X The relative efficacy of benralizumab, an interleukin-5 receptor alpha–directed cytolytic monoclonal antibody that directly depletes eosinophils versus other IL-5–targeted treatments for patients with severe, uncontrolled asthma, is not yet fully characterised.We performed a matching-adjusted indirect comparison (MAIC) of benralizumab versus mepolizumab and reslizumab. Trials were selected through systematic review and evaluation of trial methods. Benralizumab patient-level data were weighted to match treatment effect–modifying patient characteristics of comparator trials before indirect efficacy comparisons.After matching adjustment, benralizumab and mepolizumab reduced exacerbations versus placebo by 52% and 49%, respectively (rate ratio [RR]: 0.94; 95% confidence interval [CI]: 0.78–1.13; N=1524) and reduced the rate of exacerbations requiring hospitalisation/emergency department visit by 52% and 52%, respectively (RR: 1.00; 95% CI: 0.57–1.75; N=1524). Benralizumab and mepolizumab similarly improved prebronchodilator forced expiratory volume in 1 second at 32 weeks (difference=0.03 L; 95% CI: −0.06–0.12; N=1443). Benralizumab and reslizumab patient populations were too dissimilar to generate a sufficient effective sample size to produce a reliable estimate for MAIC.MAIC is a robust way to indirectly compare efficacies of treatments from trials with heterogeneous patient populations. When baseline patient characteristics were matched across asthma trials, benralizumab and mepolizumab yielded similar efficacy.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Bourdin reports personal fees, non-financial support and other from AstraZeneca, grants, personal fees and other from GSK, grants, personal fees, non-financial support and other from Boehringer Ingelheim, personal fees, non-financial support and other from Novartis, personal fees and other from Teva, personal fees and other from Regeneron, personal fees, non-financial support and other from Chiesi Pharmaceuticals, personal fees, non-financial support and other from Actelion, other from Gilead, personal fees and non-financial support from Roche, outside the submitted work.Conflict of interest: Dr. Molinari has nothing to disclose.Conflict of interest: Dr. Golam reports other from AstraZeneca, outside the submitted work.Conflict of interest: Dr. Siddiqui reports other from AstraZeneca, during the conduct of the study; other from PARAXEL International, outside the submitted work.Conflict of interest: Dr. Lindner reports other from AstraZeneca, outside the submitted workConflict of interest: Dr. Xu reports other from AstraZeneca, outside the submitted work.Conflict of interest: Dr. Husereau reports other from AstraZeneca, grants, personal fees and other from GSK, outside the submitted work. %U https://erj.ersjournals.com/content/erj/early/2018/10/04/13993003.01393-2018.full.pdf