Advanced

Targeting the interleukin-4 and interleukin-13 pathways in severe asthma : Current knowledge and future needs

Parulekar, Amit D.; Kao, Christina C.; DIamant, Zuzana LU and Hanania, Nicola A. (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)
Please use this url to cite or link to this publication:
author
organization
publishing date
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
  • 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
2018-01-10 11:37:37
@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},
  keyword      = {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},
  volume       = {24},
  year         = {2018},
}