PMID- 24275927
OWN - NLM
STAT- MEDLINE
DCOM- 20140813
LR  - 20131128
IS  - 1531-6971 (Electronic)
IS  - 1070-5287 (Linking)
VI  - 20
IP  - 1
DP  - 2014 Jan
TI  - Monoclonal antibodies for the treatment of refractory asthma.
PG  - 87-94
LID - 10.1097/MCP.0000000000000007 [doi]
AB  - PURPOSE OF REVIEW: A small proportion of patients with asthma have severe disease 
      characterized by persistent airflow obstruction, airway hyperresponsiveness and 
      eosinophilic airway inflammation. This review focuses on the clinical efficacy of 
      inhibiting T helper 2-cytokine-mediated inflammatory responses using monoclonal 
      antibodies directed against immunoglobulin E (IgE), interleukin (IL)-5, and 
      IL-4/IL-13 in patients with severe refractory asthma. RECENT FINDINGS: The 
      heterogeneity of airway inflammation in severe asthma has led to the recognition 
      of multiple pathophysiologically distinct severe asthma endotypes. Biomarkers are 
      being developed and evaluated to identify these endotypes and to guide the use of 
      specific biologics in the appropriate patients who remain uncontrolled on high 
      doses of inhaled corticosteroids and long-acting bronchodilators or oral 
      corticosteroids. Examples include the efficacy of omalizumab in patients with 
      severe refractory atopic asthma characterized by raised serum total IgE, 
      mepolizumab, reslizumab, and benralizumab in patients with recurrent eosinophilic 
      exacerbations characterized by blood and sputum eosinophilia despite high doses 
      of corticosteroids, and lebrikizumab, pitrakinra, dupilumab, and tralokinumab 
      that target the IL-4/IL-13 signalling pathways in patients with eosinophilic 
      asthma or raised serum periostin. SUMMARY: In severe refractory asthma, both an 
      understanding of the underlying pathophysiologic mechanisms driving airway 
      inflammation and the identification of appropriate biomarkers in individual 
      patients are critical in guiding the use of biologics and monoclonal antibodies 
      that target the specific pathological processes.
FAU - Hambly, Nathan
AU  - Hambly N
AD  - Division of Respirology, Department of Medicine, St Joseph's Healthcare and 
      McMaster University, Hamilton, Ontario, Canada.
FAU - Nair, Parameswaran
AU  - Nair P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Curr Opin Pulm Med
JT  - Current opinion in pulmonary medicine
JID - 9503765
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Interleukin-13)
RN  - 0 (Interleukin-5)
RN  - 207137-56-2 (Interleukin-4)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Anti-Asthmatic Agents/*therapeutic use
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Asthma/*drug therapy/metabolism
MH  - Humans
MH  - Immunoglobulin E/immunology/metabolism
MH  - Interleukin-13/immunology/metabolism
MH  - Interleukin-4/immunology/metabolism
MH  - Interleukin-5/immunology/metabolism
MH  - *Severity of Illness Index
MH  - Treatment Failure
MH  - Treatment Outcome
EDAT- 2013/11/28 06:00
MHDA- 2014/08/15 06:00
CRDT- 2013/11/27 06:00
PHST- 2013/11/27 06:00 [entrez]
PHST- 2013/11/28 06:00 [pubmed]
PHST- 2014/08/15 06:00 [medline]
AID - 10.1097/MCP.0000000000000007 [doi]
PST - ppublish
SO  - Curr Opin Pulm Med. 2014 Jan;20(1):87-94. doi: 10.1097/MCP.0000000000000007.