Anti-IL-5 monoclonal antibodies for the treatment of asthma: an update

ABSTRACT

Introduction

Asthma exhibits marked heterogeneity in symptoms with severe or refractory asthma representing a clear area of unmet medical need. These patients require more specifically targeted treatments with monoclonal antibody–based biologics targeted at inhibition of the type 2 cytokines IL-4, IL-5 and IL-13 having considerable potential as effective treatments for severe asthma. For the most part, anti-cytokine-based biologic therapies are more likely to give significant clinical benefit in carefully selected patient populations that take asthma phenotypes and endotypes into account.

Areas covered

This review is based on recent English-language original articles in Pub Med or MedLine that reported significant clinical findings on the current status, therapeutic potential and safety of the anti-IL-5 biologics mepolizumab, reslizumab and benralizumab in the treatment of severe refractory asthma.

Expert opinion

Anti-IL-5 treatment appears effective in patients with eosinophilic asthma through exacerbation prevention with accumulating evidence of glucocorticoid-sparing effects with an acceptable safety profile for these biologics.

KEYWORDS:

• Asthma
• il-5
• eosinophils
• biologics
• mepolizumab
• reslizumab
• benralizumab

Article highlights

• Anti-IL-5 biologic-based treatments are effective in patients with specific phenotypes of glucocorticoid-resistant severe asthma characterized by eosinophilia receiving therapy according to GINA Step 5.

• These medications reduce exacerbation rates and glucocorticoid use, together with improvements in lung function and patient-reported outcomes.

• There is a requirement for further research on biomarkers that would aid the assessment of response to these treatments.

• There appear to be no significant safety concerns regarding these biologic-based treatments for moderate to severe refractory asthma.

This box summarizes key points contained in the article.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper is not funded.