: The overall efficacy and safety of anti-interleukin IL -13 therapies remain to be fully characterized. We conducted a meta-analysis of randomized controlled trials RCTs on the efficacy and safety of anti-IL-13 therapies compared with placebo in patients with uncontrolled asthma. This meta-analysis complied with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses PRISMA guidelines. The primary efficacy outcome was pulmonary function, and the primary safety outcome was the incidence rate of all adverse events AAEs . Secondary outcomes included asthma exacerbation, asthma control, and asthma-related quality of life QoL . Pooled estimates are presented as mean differences MDs , hazard ratios HRs or risk ratios RRs with 95 condence intervals CIs . Five RCTs of anti-IL-13 therapies, including tralokinumab, GSK679586, or lebrikizumab, met the criteria for study inclusion. The overall MD for change in forced expiratory volume in 1 second was 0.08 95 CI 0.02, 0.15 .

: High serum triglyceride TG levels may lower bone fracture risk, but the association between serum TG and bone resorption activity is unclear. The aim of the present study was to analyze this association using casual serum TG levels in patients with and without accelerated bone resorption. A case-control study was performed in 39 patients with accelerated bone resorption and in 69 controls, treated between April 2011 and March 2016 at the Internal Medicine Clinic. Bone resorption activity was assessed by urinary N-telopeptide of type I collagen uNTx ; a marker of bone resorption , which is routinely measured at the Internal Medicine Clinic. Cases were female outpatients aged ≥ 40 years in whom uNTx levels were ≥ 54.3 nmol bone collagen equivalent BCE / mmol creatinine. Subjects with casual serum TG levels 150 mg / dl were diagnosed with potential hypertriglyceridemia PHTG . Propensity score-adjusted multinomial logistic regression was performed to estimate the odds ratios ORs and corresponding 95 con dence intervals CIs for PHTG in cases compared with controls. Correlations between uNTX and casual serum TG levels in all patients were evaluated using multivariate regression. The prevalence of PHTG was signi cantly lower in cases than in controls OR 0.20 ; 95 CI 0.05 0.65 ; P 0.006 . uNTx levels were negatively associated with casual serum TG levels in all patients r 0.07, P 0.046 . These results suggest that serum TG levels are negatively associated with bone resorption activity. Reduced bone resorption activity may explain, in part, the reduced fracture risk in Japanese middle-aged and elderly female patients with hypertriglyceridemia.

: The aim of the present study was to assess the non-inferiority of lowdose benralizumab relative to high-dose benralizumab as a treatment option for uncontrolled eosinophilic asthma through a meta-analysis of ef cacy and safety in randomized controlled trials RCTs . PubMed, the Cochrane Library Database, and Scopus were searched to identify relevant articles. Outcome measures were a change in the Asthma Control Questionnaire-6 ACQ-6 score and the exacerbation rate. In addition, the meta-analysis assessed the incidence of adverse events, injection site reactions, and pyrexia or influenza-like illness. Two RCTs with two doses of benralizumab 20 and 100 mg and a placebo for the treatment of uncontrolled eosinophilic asthma met the criteria and were included in the present study. Non-inferiority of low-dose 20 mg versus high-dose 100 mg benralizumab was shown for the change in ACQ-6 score, exacerbation rate, and the incidence of adverse events, injection site reactions, and pyrexia or influenza-like illness. Although not signi cant, the incidence of pyrexia or in uenza-like illness was lower in patients treated with low-dose benralizumab. These results suggest that low-dose 20 mg benralizumab is effective for symptom control and reduction of exacerbation rate in uncontrolled eosinophilic asthma, with lower treatment costs.

: The aim of this study was to assess the non-inferiority of on-demand OD inhaled corticosteroid ICS and fast-acting beta-2 agonist FABA combination therapy. Although regular inhalation of low-dose ICS and OD short-acting beta-2 agonist REG-ICS OD-SABA is said to be effective therapy for mild asthma, we investigated whether OD-ICS / FABA is as effective as REG-ICS OD-SABA. A network meta-analysis of randomized controlled trials was conducted to examine non-inferiority by comparing the ef cacy of NON-REG OD-ICS / FABA with REG-ICS OD-SABA for mild asthma. We also assessed the superiority of NON-REG OD-ICS / FABA to OD-SABA without any regular treatment NON-REG OD-SABA . PubMed, the Cochrane library database, and Scopus were searched to identify relevant articles with an outcome measure of the incidence of asthma control. A network meta-analysis was performed and the summary effect size was expressed as the mean difference MD with 95 con dence intervals CIs . The probability of being the best treatment for the outcome and the surface under the cumulative ranking curves were also calculated. Three randomized controlled trials of treatment for mild asthma met the criteria and were included in the study. Non-inferiority of NON-REG OD-ICS / FABA to REG-ICS OD-SABA MD, 0.17 ; 95 CI, 0.41 to 0.07 and superiority of NON-REG OD-ICS / FABA to NON-REG OD-SABA MD, 0.29 ; 95 CI, 0.49 to 0.08 were shown in patients with mild asthma. The respective probabilities of being the best treatment for asthma control were 91.2 , 8.8 and 0.2 for NON-REG OD-ICS / FABA, REG-ICS OD-SABA, and NON-REG OD-SABA, respectively, and the surface under the cumulative ranking curves were 1.0, 0.5, and 0.1, respectively. These results suggest that NON-REG OD-ICS / FABA is an effective alternative to REG-ICS OD-SABA for asthma control in patients with mild asthma.

The aim of the present study was to assess the overall efficacy and safety of long-acting beta-2 agonist LABA and long-acting muscarinic antagonist LAMA combination therapies LABA/LAMA versus monotherapies or placebo in patients with chronic obstructive pulmonary disease COPD. The overall ef cacy and safety of LABA/LAMA versus LABA, LAMA, or placebo in patients with COPD were assessed by meta-analysis of Phase 3 trials. Primary efficacy outcomes included changes in forced expiratory volume in 1 second FEV 1.0 from baseline and responder rates using St. George s Respiratory Questionnaire SGRQ. The incidence of serious adverse events SAEs was the primary safety outcome. Pooled estimates are presented as standard mean differences SMD , odds ratios ORs , or risk differences RDs with 95% con dence intervals CIs. Eleven articles reporting on 13 randomized controlled trials of LABA/LAMA met the criteria for inclusion in the present study. Comparing LABA/LAMA with LAMA, LABA, and placebo, the SMD 95% CI for a change in FEV 1.0 from baseline was 0.