An Overview of the Safety and Efficacy of Monoclonal Antibodies for the Chronic Obstructive Pulmonary Disease

Abstract

Several mAbs have been tested or are currently under clinical evaluation for the treatment of COPD. They can be subdivided into those that aim to block specific pro-inflammatory and pro-neutrophilic cytokines and chemokines, such as TNF-α, IL-1β, CXCL8 and IL-1β, and those that act on T2-mediated inflammation, respectively, by blocking IL-5 and/or its receptor, preventing IL-4 and IL-13 signaling, affecting IL-33 pathway and blocking TSLP. None of these approaches has proved to be effective, probably because in COPD there is no dominant cytokine or chemokine and, therefore, a single mAb cannot be effective on all pathways. With a more in-depth understanding of the numerous pheno/endotypic pathways that play a role in COPD, it may eventually be possible to identify those specific patients in whom some of these cytokines or chemokines might predominate. In this case, it will be possible to implement a personalized treatment, but the use of each mAb will only be reserved for a very limited number of subjects.

Keywords:

• COPD
• monoclonal antibodies
• pheno/endotypic pathways
• anti–T1-mediated inflammation mAbs
• anti–T2-mediated inflammation mAbs

Disclosure

Professor Mario Cazzola reports grants and personal fees from Almirall, Boehringer Ingelheim, Novartis, and Zambon and personal fees from ABC Farmaceutici, AstraZeneca, Biofutura, Chiesi Farmaceutici, Cipla, Edmond Pharma, GlaxoSmithKline, Lallemand, Menarini, Mundipharma, Ockham Biotech, Pfizer, Sanofi, and Verona Pharma, outside the submitted work. Professor Paola Rogliani reports grants, personal fees, non-financial support from Almirall, AstraZeneca, Biofutura, Boehringer Ingelheim, Chiesi Farmaceutici, GlaxoSmithKline, Menarini Group, Mundipharma, and Novartis, and her department was funded by Almirall, Boehringer Ingelheim, Chiesi Farmaceutici Novartis, and Zambon. Professor Maria Gabriella Matera reports grants and personal fees from GlaxoSmithKline, and Novartis and personal fees from ABC Farmaceutici, AstraZeneca, and Chiesi Farmaceutici, outside the submitted work The authors declare no other competing interests in this work.

Additional information

Funding

No funding was utilized in the creation of this review.