Novel monoclonal treatments in severe asthma

ABSTRACT

Aim: To provide a general overview of the current biological treatments and discuss their potential anti-asthmatic effects. Data sources: We reviewed articles in PubMed found using the search words “Asthma/therapy AND antibodies, monoclonal/therapeutic use AND cytokines.” Study selections: Only articles published in English since 2000 were considered. The search identified 29 studies; 8 additional studies were found by hand search, generating 37 studies. Results: Of the 37 studies investigating biological treatments of asthma, 5 were on the effects of anti-IgE (omalizumab); 12 on anti-IL-5; 8 on anti-IL-13; 5 on anti-IL-4R-α; 3 on anti-IL-9; one on TNF-α; one on anti-IL-2R-α; one on TSLP (Thymic Stromal Lymphopoietin); and one on OX40L. Sample sizes ranged from 3 to 943 participants. Studies of therapies targeting IgE, IL-2, IL4R-α, IL-5, and IL-13 showed some efficacy, whereas those targeting TSLP, IL-9, and TNF-α lacked convincing effectiveness. Conclusion: Research on the biological treatment of asthma shows promising results. While anti-IgE (omalizumab) has been used in the treatment of asthma for some years, anti-IL-5 has recently been approved for use. The efficacy of results of other large studies with a longer duration is needed to draw a firm conclusion. Such studies should not only focus on clinical outcomes, but also consider asthma-related quality of life. Knowledge on the asthma phenotypes and identification of biomarkers associated with these will be useful for physicians considering the right treatment for the asthma patient.

KEYWORDS:

• Asthma
• treatment
• monoclonal
• review

Declaration of interest

The authors alone are responsible for the content and writing of this article. Vibeke Backer has research cooperation with Novartis, AstraZeneca, Boehringer-Ingelheim, and GlaxoSmithKline, but has received no direct financial support for this review paper. Celeste Porsbjerg has received honoraria for scientific presentations and consultancies from Novartis, Astra Zeneca, and GSK. Celeste Porsbjerg has not received direct financial support for this review paper. Howraman Meteran has received honoraria for scientific presentations from Sandoz as well as research cooperation. Howraman Meteran has received honoraria for writing a scientific pamphlet for GlaxoSmithKline, but had no direct financial support for this review paper. Hanieh Meteran has no conflict of interest.