Targeting the interleukin-4 and interleukin-13 pathways in severe asthma : Current knowledge and future needs
(2018) In Current Opinion in Pulmonary Medicine 24(1). p.50-55- Abstract
Purpose of review Severe asthma is a heterogeneous disease that can be classified into phenotypes and endotypes based upon clinical or biological characteristics. Interleukin (IL)-4 and IL-13 play a key role in type 2 (T2) asthma. This article reviews the signaling pathway of IL-4 and IL-13 and highlights its targeted therapy in severe asthma. Recent findings Several clinical trials of biologics targeting the IL-4/IL-13 pathway have recently been completed. In patients with severe, uncontrolled asthma, targeting IL-13 alone with biologics including lebrikizumab and tralokinumab has not shown consistent reduction in asthma exacerbations. Simultaneous targeting of both IL-4 and IL-13 by blocking IL-4 receptor α using dupilumab has yielded... (More)
Purpose of review Severe asthma is a heterogeneous disease that can be classified into phenotypes and endotypes based upon clinical or biological characteristics. Interleukin (IL)-4 and IL-13 play a key role in type 2 (T2) asthma. This article reviews the signaling pathway of IL-4 and IL-13 and highlights its targeted therapy in severe asthma. Recent findings Several clinical trials of biologics targeting the IL-4/IL-13 pathway have recently been completed. In patients with severe, uncontrolled asthma, targeting IL-13 alone with biologics including lebrikizumab and tralokinumab has not shown consistent reduction in asthma exacerbations. Simultaneous targeting of both IL-4 and IL-13 by blocking IL-4 receptor α using dupilumab has yielded more consistent results in reducing asthma exacerbations and improving lung function, especially in patients with increased blood eosinophils. Other biomarkers of T2 inflammation such as exhaled nitric oxide and serum periostin may also predict response to biologics targeting the IL-4/IL-13 pathway. Summary No biologic targeting the IL-4/IL-13 pathway is currently available for treatment of asthma, but emerging data suggest that biologics targeting IL-4 and IL-13 together may benefit patients with T2 high asthma. Additional data are needed about long-term efficacy and safety prior to incorporating these drugs into routine clinical practice.
(Less)
- author
- Parulekar, Amit D. ; Kao, Christina C. ; DIamant, Zuzana LU and Hanania, Nicola A.
- organization
- publishing date
- 2018-01-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- biologics, dupilumab, lebrikizumab, T2 asthma, tralokinumab
- in
- Current Opinion in Pulmonary Medicine
- volume
- 24
- issue
- 1
- pages
- 6 pages
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:29036019
- scopus:85036668790
- ISSN
- 1070-5287
- DOI
- 10.1097/MCP.0000000000000436
- language
- English
- LU publication?
- yes
- id
- 6a6e535a-f17d-4d9e-a859-12bc3d9f3c22
- date added to LUP
- 2018-01-02 14:38:30
- date last changed
- 2024-09-16 13:17:10
@article{6a6e535a-f17d-4d9e-a859-12bc3d9f3c22, abstract = {{<p>Purpose of review Severe asthma is a heterogeneous disease that can be classified into phenotypes and endotypes based upon clinical or biological characteristics. Interleukin (IL)-4 and IL-13 play a key role in type 2 (T2) asthma. This article reviews the signaling pathway of IL-4 and IL-13 and highlights its targeted therapy in severe asthma. Recent findings Several clinical trials of biologics targeting the IL-4/IL-13 pathway have recently been completed. In patients with severe, uncontrolled asthma, targeting IL-13 alone with biologics including lebrikizumab and tralokinumab has not shown consistent reduction in asthma exacerbations. Simultaneous targeting of both IL-4 and IL-13 by blocking IL-4 receptor α using dupilumab has yielded more consistent results in reducing asthma exacerbations and improving lung function, especially in patients with increased blood eosinophils. Other biomarkers of T2 inflammation such as exhaled nitric oxide and serum periostin may also predict response to biologics targeting the IL-4/IL-13 pathway. Summary No biologic targeting the IL-4/IL-13 pathway is currently available for treatment of asthma, but emerging data suggest that biologics targeting IL-4 and IL-13 together may benefit patients with T2 high asthma. Additional data are needed about long-term efficacy and safety prior to incorporating these drugs into routine clinical practice.</p>}}, author = {{Parulekar, Amit D. and Kao, Christina C. and DIamant, Zuzana and Hanania, Nicola A.}}, issn = {{1070-5287}}, keywords = {{biologics; dupilumab; lebrikizumab; T2 asthma; tralokinumab}}, language = {{eng}}, month = {{01}}, number = {{1}}, pages = {{50--55}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Current Opinion in Pulmonary Medicine}}, title = {{Targeting the interleukin-4 and interleukin-13 pathways in severe asthma : Current knowledge and future needs}}, url = {{http://dx.doi.org/10.1097/MCP.0000000000000436}}, doi = {{10.1097/MCP.0000000000000436}}, volume = {{24}}, year = {{2018}}, }