PMID- 30115042
OWN - NLM
STAT- MEDLINE
DCOM- 20190122
LR  - 20220331
IS  - 1465-993X (Electronic)
IS  - 1465-9921 (Print)
IS  - 1465-9921 (Linking)
VI  - 19
IP  - 1
DP  - 2018 Aug 16
TI  - The use of intravenous versus subcutaneous monoclonal antibodies in the treatment 
      of severe asthma: a review.
PG  - 154
LID - 10.1186/s12931-018-0859-z [doi]
LID - 154
AB  - BACKGROUND: Monoclonal antibodies (mAbs) approved for use as add-on therapy in 
      patients with severe asthma target the underlying pathogenesis of asthma. MAIN 
      BODY: Omalizumab binds immunoglobulin E (IgE), thereby inhibiting its interaction 
      with the high-affinity IgE receptor and reducing the quantity of free IgE 
      available to trigger the allergic cascade. Anti-interleukin (IL)-5 mAbs 
      mepolizumab, benralizumab and reslizumab block the interaction between IL-5 and 
      its receptor on eosinophils, thus targeting the eosinophilic pathway in asthma. 
      Most mAbs are available as intravenous (IV) or subcutaneous (SC) formulations, as 
      their high molecular weight and gastric degradation preclude oral administration. 
      This review compares the pharmacology, efficacy, immunogenicity, injection- and 
      infusion-related adverse drug reactions of subcutaneously administered omalizumab 
      and mepolizumab with the intravenously administered reslizumab. In terms of 
      pharmacokinetics, IV route of administration appears to be superior to the SC 
      route due to quicker absorption, greater bioavailability, shorter time to maximum 
      serum concentration and similar elimination half-life. Route of administration 
      does not appear to translate into striking differences in efficacy and safety of 
      mAbs used for the treatment of severe asthma, as all are generally considered to 
      be effective and well tolerated. Hypersensitivity and administration-related 
      reactions have been described with both IV and SC mAbs. CONCLUSION: mABs are 
      effective and have low immunogenicity due to their nature as humanised 
      antibodies. Evidence on the use of mAbs in indications other than severe asthma 
      suggest that both the SC and the IV routes of administrations have their 
      respective advantages and disadvantages; but their full utility remains to be 
      elucidated.
FAU - Matucci, Andrea
AU  - Matucci A
AD  - Immunoallergology Unit, AOU Careggi, University of Florence, Largo Brambilla 3, 
      50134, Florence, Italy. andrea.matucci@unifi.it.
FAU - Vultaggio, Alessandra
AU  - Vultaggio A
AD  - Immunoallergology Unit, AOU Careggi, University of Florence, Largo Brambilla 3, 
      50134, Florence, Italy.
FAU - Danesi, Romano
AU  - Danesi R
AD  - Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and 
      Experimental Medicine, University of Pisa, Pisa, Italy.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Review
DEP - 20180816
PL  - England
TA  - Respir Res
JT  - Respiratory research
JID - 101090633
RN  - 0 (Anti-Asthmatic Agents)
RN  - 0 (Antibodies, Monoclonal)
SB  - IM
MH  - Administration, Intravenous
MH  - Anti-Asthmatic Agents/*administration & dosage
MH  - Antibodies, Monoclonal/*administration & dosage
MH  - Asthma/*diagnosis/*drug therapy
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Randomized Controlled Trials as Topic/methods
MH  - *Severity of Illness Index
MH  - Treatment Outcome
PMC - PMC6097430
OTO - NOTNLM
OT  - Eosinophil
OT  - Mepolizumab
OT  - Monoclonal antibodies
OT  - Omalizumab
OT  - Reslizumab
OT  - Severe asthma
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: AM and AV have received payment 
      for lectures and consultant arrangements from Novartis, Glaxo-Smith-Kline, Teva, 
      Astra-Zeneca. AM and AV have received research support from Novartis, 
      Glaxo-Smith-Kline and Sanofi. RD receives research fundings from Pfizer, 
      Boehringher, AstraZeneca, Novartis and Celgene and honoraria from Pfizer, 
      Boehringher, AstraZeneca, Novartis, Janssen, Roche and Celgene. The authors 
      declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature 
      remains neutral with regard to jurisdictional claims in published maps and 
      institutional affiliations.
EDAT- 2018/08/18 06:00
MHDA- 2019/01/23 06:00
PMCR- 2018/08/16
CRDT- 2018/08/18 06:00
PHST- 2018/05/14 00:00 [received]
PHST- 2018/08/08 00:00 [accepted]
PHST- 2018/08/18 06:00 [entrez]
PHST- 2018/08/18 06:00 [pubmed]
PHST- 2019/01/23 06:00 [medline]
PHST- 2018/08/16 00:00 [pmc-release]
AID - 10.1186/s12931-018-0859-z [pii]
AID - 859 [pii]
AID - 10.1186/s12931-018-0859-z [doi]
PST - epublish
SO  - Respir Res. 2018 Aug 16;19(1):154. doi: 10.1186/s12931-018-0859-z.