Biologics and chronic obstructive pulmonary disease - 06/06/18
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Abstract |
The presence of airway inflammation in patients with chronic obstructive pulmonary disease (COPD) provides a rationale for biological agents targeting specific inflammatory pathways. This approach has been strikingly effective in patients with other chronic inflammatory diseases, such as rheumatoid arthritis, psoriasis, and asthma. However, there are important and unresolved challenges in COPD, including our incomplete understanding of heterogeneity of the lower airway inflammatory response and how these contribute to the clinical expression of disease. As a result, progress has been slow, and there have been many failures. One notable exception is the targeting of eosinophilic airway inflammation with anti–IL-5, which has an acknowledged and important role in the treatment of severe eosinophilic asthma. Recent phase III studies have shown a reduction in exacerbations of around 20% in patients with COPD and clear evidence of a blood eosinophil count–dependent beneficial effect. The demonstration of clinical efficacy linked to a clinically accessible biomarker raises the possibility of precision biomarker–directed use of biological agents in patients with COPD. The hope is that this will be an exemplar for the future development of biological agents in patients with COPD.
Le texte complet de cet article est disponible en PDF.Key words : Biologics, chronic obstructive pulmonary diseases
Abbreviations used : COPD, Feno, ICS, METREO, METREX
Plan
Disclosure of potential conflict of interest: In the last 5 years, I. D. Pavord has received speakers' honoraria for speaking at sponsored meetings from AstraZeneca, Boehringer Ingelheim, Aerocrine, Almirall, Novartis, Teva, Chiesi, and GlaxoSmithKline and payments for organizing educational events from AstraZeneca and Teva; has received honoraria for attending advisory panels with Genentech, Regeneron, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Teva, Merck, Sanofi, Circassia, Chiesi, and Knopp; has received sponsorship to attend international scientific meetings from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Teva, and Chiesi; and has received a grant from Chiesi to support a phase 2 clinical trial in Oxford. |
Vol 141 - N° 6
P. 1983-1991 - juin 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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