New Monoclonal Antibody Treatment Is Effective for Asthma
A new monoclonal antibody, itepekimab, may improve asthma control in individuals with moderate to severe asthma, according to the results of a recent study.
The researchers conducted a phase 2 trial to examine the safety and efficacy of this new monoclonal antibody. Itepekimab is designed to target interleukin-33, a cytokine protein.
Included were 296 adults with moderate to severe asthma receiving inhaled glucocorticoids plus long-acting β-agonists (LABAs). Participants were randomly assigned to 1 of 4 treatments: 300 mg of itepekimab, 300 mg of itepekimab plus 300 mg of dupilumab, 300 mg of dupilumab, or placebo. Participants took their assigned treatment every 2 weeks for the duration of the 12-week study period. LABA was discontinued at week 4. Inhaled glucocorticoids were tapered from weeks 6 through 9.
The primary outcome, an event indicating a loss of asthma control, occurred in 22% of individuals in the itepekimab group, 27% in the combination group, 19% in the dupilumab group, and 41% in the placebo group by week 12.
The forced expiratory volume in 1 second before bronchodilator use increased with both itepekimab and dupilumab monotherapies compared with placebo. However, the forced expiratory volume in 1 second did not increase with the combination therapy. Asthma control and quality of life were improved with itepekimab compared with placebo. Treatment with itepekimab also led to a greater reduction in the mean blood eosinophil count. For all 4 groups, the incidence of adverse events was similar.
“Interleukin-33 blockade with itepekimab led to a lower incidence of events indicating a loss of asthma control than placebo and improved lung function in patients with moderate to severe asthma,” the researchers concluded.
Wechsler ME, Ruddy MK, Pavord ID, et al. Efficacy and safety of itepekimab in patients with moderate-to-severe asthma. N Engl J Med. 2021;385(18):1656-1668 doi:10.1056/NEJMoa2024257