Lebrikizumab treatment in adults with asthma

January 01, 0001

Lebrikizumab treatment in adults with asthma

Many patients with asthma have uncontrolled disease despite treatment with inhaled glucocorticoids. One potential cause of the variability in response to treatment is heterogeneity in the role of interleukin-13 expression in the clinical asthma phenotype. In this manufacturer sponsored study the authors hypothesized that anti-interleukin-13 therapy would benefit patients with asthma who had a pretreatment profile consistent with interleukin-13 activity. They conducted a randomized, double-blind, placebo- controlled study of lebrikizumab, a monoclonal antibody to interleukin-13, in 219 adults who had asthma that was inadequately controlled despite inhaled glucocorticoid therapy.

They found: "At baseline, patients had a mean FEV1 that was 65% of the predicted value and were taking a mean dose of inhaled glucocorticoids of 580 mcg per day; 80% were also taking a long-acting beta-agonist. At week 12, the mean increase in FEV1 was 5.5 percentage points higher in the lebrikizumab group than in the placebo group. Among patients in the high-periostin subgroup, the increase from baseline FEV1 was 8.2 percentage points higher in the lebrikizumab group than in the placebo group. Among patients in the low- periostin subgroup, the increase from baseline FEV1 was 1.6 percentage points higher in the lebrikizumab group than in the placebo group (NS). Musculoskeletal side effects were more common with lebrikizumab than with placebo (13.2% vs. 5.4%)."

The authors concluded: "Lebrikizumab treatment was associated with improved lung function. Patients with high pretreatment levels of serum periostin had greater improvement in lung function with lebrikizumab than did patients with low periostin levels."

Lebrikizumab appears promising for treatment of adults with severe persistent asthma and inadequate control with inhaled corticosteroids. Larger studies are needed to assess safety.

For the full abstract, click here.

N Engl J Med online 3 August 2011 © 2011 to the Massachusetts Medical Society
Lebrikizumab Treatment in Adults with Asthma. Jonathan Corren, Robert F. Lemanske, Nicola A. Hanania, et al. Correspondence to John Matthews: [email protected]

Category: R. Respiratory. Keywords: asthma, lebrikizumab, inhaled corticosteroid, interleukin-13, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 16 August 2011

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