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Dupilumab in the management of moderate-to-severe asthma: the data so far

Authors Barranco P, Phillips-Angles E, Dominguez-Ortega J, Quirce S

Received 1 July 2017

Accepted for publication 17 August 2017

Published 1 September 2017 Volume 2017:13 Pages 1139—1149

DOI https://doi.org/10.2147/TCRM.S125964

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh

Pilar Barranco,1 Elsa Phillips-Angles,2 Javier Dominguez-Ortega,1 Santiago Quirce1

1Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; 2Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain

Abstract: Severe asthma constitutes illness in a relatively small proportion of all patients with asthma, but it is a major public health problem – with considerable effect on morbidity, mortality, as well as a high burden on health care resources. Regardless of effective treatments being widely available and the existence of treatment guidelines, a large population of severe asthma cases remain uncontrolled. Achieving and maintaining asthma control in this group of patients is, therefore, of utmost importance. The recognition of distinct inflammatory phenotypes within this population has driven the development of targeted biological therapies – particularly, selective targeted monoclonal antibodies (mAbs). It is noteworthy that in approximately 50% of these patients, there is strong evidence of the pathogenic role of T helper type-2 (Th2) cytokines, such as interleukin (IL)-4 and IL-13, orchestrating the eosinophilic and allergic inflammatory processes. Among the recently developed antiasthma biologic drugs, the mAb dupilumab is very promising given its ability to inhibit the biological effects of both IL-4 and IL-13. In this review, we focused on IL-4 and IL-13, as these interleukins are considered to play a key role in the pathophysiology of asthma, and on dupilumab, an anti-IL-4 receptor human mAb, as a forthcoming treatment for uncontrolled severe asthma in the near future.

Keywords: dupilumab, asthma, interleukin-4, interleukin-13, monoclonal antibodies, treatment

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