Emerging treatments

Lebrikizumab

Lebrikizumab is a humanised immunoglobulin G4 (IgG4) monoclonal antibody that binds to interleukin-13 and inhibits its function.[128] In phase 2 clinical trials, lebrikizumab reduced exacerbation rates and improved lung function in patients with uncontrolled asthma.[128][129] Efficacy was most pronounced in patients with high levels of blood eosinophils and periostin, both markers of type 2 inflammation.[128][129] Lebrikizumab subsequently failed to demonstrate consistent efficacy in biomarker-high patients in its pivotal phase 3 studies, and its development in asthma was discontinued in 2016.[130] However, in 2021, authors of a post-hoc analysis of the phase 3 data found that patients enrolled in the trials may have been underdosed, opening up the possibility of new trials at higher doses.[131] One study of lebrikizumab in adolescent patients aged 12-17 years showed promising efficacy results but was prematurely terminated.[132] Meanwhile, the US Food and Drug Administration has granted fast-track designation for lebrikizumab for the treatment of moderate-to-severe atopic dermatitis.

Itepekimab

Itepekimab is a human IgG4 monoclonal antibody directed against interleukin-33, an upstream epithelial alarmin involved in airway inflammation.[133][134] In a phase 2 study of patients with moderate-to-severe asthma, itepekimab monotherapy was associated with fewer loss-of-control asthma events than dupilumab monotherapy, dupilumab plus itepekimab, or placebo.[135] Itepekimab is also under clinical investigation in patients with chronic obstructive pulmonary disease.[136]

Use of this content is subject to our disclaimer