Pharmacokinetics and pharmacodynamics of monoclonal antibodies for asthma treatment

ABSTRACT

Introduction: Asthma is a chronic inflammatory airway disease. It occurs in a ‘severe’ form in about 8–10% of asthmatic patients. In the last decade, the development of biological drugs (e.g. monoclonal antibodies) allowed to efficiently approach severe asthma. The current therapeutic targets available are mainly those related to TH2 inflammation.

Areas covered: The main pharmacokinetic and pharmacodynamic characteristics of the monoclonal antibodies against IL-5, IL-5Ra, IL4-IL13, and IgE, that are currently marketed or understood for severe asthma are discussed in this paper.

Expert opinion: The currently available biological drugs represent an excellent therapeutic add-on to traditional drugs, especially in replacing systemic corticosteroid therapies. The different pharmacokinetic and pharmacodynamic characteristics of the drugs, despite sometime sharing the same target, would allow a better personalization of the therapy, tailoring the treatment to the characteristics of the patient.

KEYWORDS:

• Severe asthma
• pharmacokinetic
• pharmacodynamics
• monoclonal antibodies
• biological drugs
• precision medicine
• personalized medicine

Article highlights

1. Monoclonal antibodies are an efficient therapy in patients with severe asthma

2. Biological drugs currently marketable can be used in patients with an allergic or an eosinophilic phenotype of asthma

3. The pharmacokinetic and pharmacodynamic aspect of these drugs makes them different from each other despite, in some cases, the biological target is the same

4. The point of inoculum of these drugs modifies the pharmacokinetics mechanisms; therefore, it is necessary to use the one suggested by clinical trials to guarantee a correct absorption

5. Although these drugs have different routes of administration, they have proved equally effective, despite this modifying PK and PD

This box summarizes key points contained in the article.

Acknowledgments

Assistance for this paper was provided by CIPRO (Centro Interprofessionale Pneumologico Ricerca Organizzazione) and ARMIA (Associazione Ricerca Malattie Immunologiche e Allergiche) Genova.

Declaration of interest

The authors have 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.

Additional information

Funding

This paper was not funded.