Cargando…

Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review

BACKGROUND: Asthma affects millions of patients across the globe and also accounts for numerous mortalities every year. The current pharmacologic approach to the treatment of asthma includes the use of glucocorticoids and beta-agonists mainly. However, these conventional therapies have poor controll...

Descripción completa

Detalles Bibliográficos
Autores principales: Rathinam, Kiran Kumar, Abraham, Justin Jacob, Vijayakumar, Thangavel Mahalingam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911908/
https://www.ncbi.nlm.nih.gov/pubmed/31871508
http://dx.doi.org/10.1016/j.curtheres.2019.100571
_version_ 1783479345028792320
author Rathinam, Kiran Kumar
Abraham, Justin Jacob
Vijayakumar, Thangavel Mahalingam
author_facet Rathinam, Kiran Kumar
Abraham, Justin Jacob
Vijayakumar, Thangavel Mahalingam
author_sort Rathinam, Kiran Kumar
collection PubMed
description BACKGROUND: Asthma affects millions of patients across the globe and also accounts for numerous mortalities every year. The current pharmacologic approach to the treatment of asthma includes the use of glucocorticoids and beta-agonists mainly. However, these conventional therapies have poor controllability of moderate-to-severe asthma and also produce several side effects on their long-term use. These limitations had led to the development of biologics targeting the mediators involved in T helper 2-inflammation associated with the pathogenesis of asthma such as interleukin (IL) 4, IL-5, and IL-13. dupilumab, a fully human monoclonal antibody, an IL-4 receptor alpha-antagonist targeting IL-13 and IL-4 has a potential role in treatment of moderate-to-severe asthma and was approved by the Food and Drug Administration on October 19, 2018. The dual-antagonistic action of dupilumab on IL-4 and IL-13 receptors renders it more efficient in asthma treatment. OBJECTIVES: To review the efficacy and safety profile of dupilumab in the treatment of moderate-to-severe asthma. METHODS: Systematic search was performed via PubMed, Cochrane library, Embase, and ClinicalTrials.gov using the key words dupilumab, moderate-to-severe asthma, interleukin, IL-13, IL-4, and monoclonal antibody. Randomized controlled trials that compared between placebo and dupilumab in patients with uncontrolled asthma were included and observational studies were excluded in this review. RESULTS: The review of selected literature reveals that addition of dupilumab to conventional therapy improves forced expiratory volume in 1 second and reduces the risk of severe asthma exacerbations in patients. No significant differences in incidence of adverse drug reactions/adverse drug events were observed between dupilumab and placebo groups except higher rates of injection site reactions in the dupilumab group. CONCLUSIONS: Concomitant use of dupilumab with long-acting beta agonists used in combination with inhaled corticosteroids, improves clinical outcomes and quality of life in patients with moderate to severe asthma. Although dupilumab has a promising role in treatment of patients with asthma, it is still in the emerging stage for its acceptance globally. Ongoing studies will help to determine dupilumab's long-term efficacy and safety for its future extensive use.
format Online
Article
Text
id pubmed-6911908
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-69119082019-12-23 Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review Rathinam, Kiran Kumar Abraham, Justin Jacob Vijayakumar, Thangavel Mahalingam Curr Ther Res Clin Exp Review Article BACKGROUND: Asthma affects millions of patients across the globe and also accounts for numerous mortalities every year. The current pharmacologic approach to the treatment of asthma includes the use of glucocorticoids and beta-agonists mainly. However, these conventional therapies have poor controllability of moderate-to-severe asthma and also produce several side effects on their long-term use. These limitations had led to the development of biologics targeting the mediators involved in T helper 2-inflammation associated with the pathogenesis of asthma such as interleukin (IL) 4, IL-5, and IL-13. dupilumab, a fully human monoclonal antibody, an IL-4 receptor alpha-antagonist targeting IL-13 and IL-4 has a potential role in treatment of moderate-to-severe asthma and was approved by the Food and Drug Administration on October 19, 2018. The dual-antagonistic action of dupilumab on IL-4 and IL-13 receptors renders it more efficient in asthma treatment. OBJECTIVES: To review the efficacy and safety profile of dupilumab in the treatment of moderate-to-severe asthma. METHODS: Systematic search was performed via PubMed, Cochrane library, Embase, and ClinicalTrials.gov using the key words dupilumab, moderate-to-severe asthma, interleukin, IL-13, IL-4, and monoclonal antibody. Randomized controlled trials that compared between placebo and dupilumab in patients with uncontrolled asthma were included and observational studies were excluded in this review. RESULTS: The review of selected literature reveals that addition of dupilumab to conventional therapy improves forced expiratory volume in 1 second and reduces the risk of severe asthma exacerbations in patients. No significant differences in incidence of adverse drug reactions/adverse drug events were observed between dupilumab and placebo groups except higher rates of injection site reactions in the dupilumab group. CONCLUSIONS: Concomitant use of dupilumab with long-acting beta agonists used in combination with inhaled corticosteroids, improves clinical outcomes and quality of life in patients with moderate to severe asthma. Although dupilumab has a promising role in treatment of patients with asthma, it is still in the emerging stage for its acceptance globally. Ongoing studies will help to determine dupilumab's long-term efficacy and safety for its future extensive use. Elsevier 2019-10-28 /pmc/articles/PMC6911908/ /pubmed/31871508 http://dx.doi.org/10.1016/j.curtheres.2019.100571 Text en © 2019 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Rathinam, Kiran Kumar
Abraham, Justin Jacob
Vijayakumar, Thangavel Mahalingam
Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review
title Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review
title_full Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review
title_fullStr Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review
title_full_unstemmed Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review
title_short Dupilumab in the Treatment of Moderate to Severe Asthma: An Evidence-Based Review
title_sort dupilumab in the treatment of moderate to severe asthma: an evidence-based review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6911908/
https://www.ncbi.nlm.nih.gov/pubmed/31871508
http://dx.doi.org/10.1016/j.curtheres.2019.100571
work_keys_str_mv AT rathinamkirankumar dupilumabinthetreatmentofmoderatetosevereasthmaanevidencebasedreview
AT abrahamjustinjacob dupilumabinthetreatmentofmoderatetosevereasthmaanevidencebasedreview
AT vijayakumarthangavelmahalingam dupilumabinthetreatmentofmoderatetosevereasthmaanevidencebasedreview