Biologic Therapeutics and Their Role in Allergic Disease of the Unified Airway

AbstractPurpose of ReviewRecent advances have been made in the use of biologic therapies for chronic inflammatory diseases of the unified airway. The purpose of this review is to summarize the current state of knowledge for biologic therapies in chronic airway disease, including indications for use, mechanisms of action, and future needs for research.Recent FindingsThere are currently four classes of FDA-approved biologic therapies for treatment of inflammatory airway diseases: Dupilumab (anti-IL-4R α) is approved for both moderate to severe allergic asthma and chronic rhinosinusitis with nasal polyps, including aspirin-exacerbated respiratory disease. Omalizumab (anti-IgE) is approved for persistent allergic asthma and mepolizumab, reslizumab (both anti-IL-5), and benralizumab (anti-IL-5Rα) are approved for asthma with eosinophilic endotype. Mepolizumab is also approved for eosinophilic granulomatosis with polyangiitis which affects both upper and lower airways.SummaryBiologic therapies have offered new treatment options for patients suffering with the most severe forms of allergic airway diseases. The implementation and selection of biologic agents is currently a clinical decision with consideration of disease endotype, co-morbid diseases, and shared decision-making with the patient. Future studies will help determine the comparative performance of these agents, more detailed algorithms for use, long-term outcomes, and safety profiles.
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research

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Severe asthma is a high-burden disease. Real-world data on mepolizumab in patients with severe eosinophilic asthma is needed to assess whether the data from randomised controlled trials are applicable in a broader population. The Australian Mepolizumab Registry (AMR) was established with an aim to assess the use, effectiveness and safety of mepolizumab for severe eosinophilic asthma in Australia. Patients (n=309) with severe eosinophilic asthma (median age 60 years, 58% female) commenced mepolizumab. They had poor symptom control (median Asthma Control Questionnaire (ACQ)-5 score of 3.4), frequent exacerbations (media...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Asthma and allergy Original Articles: Asthma Source Type: research
AbstractPurpose of ReviewChronic rhinosinusitis (CRS) is a heterogenous disease process affecting a significant proportion of the population and impacting quality of life and productivity. Historically, CRS has been classified broadly into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). Increased understanding regarding unique presentations of CRS subsets and their underlying inflammatory profiles has led to a new system for classifying CRS phenotypes.Recent FindingsConsideration of CRS phenotypes has traditionally been a key factor in determining treatment paradigms. Under a new phenotype classificat...
Source: Current Allergy and Asthma Reports - Category: Allergy & Immunology Source Type: research
Authors: Kim YS, Han D, Kim J, Kim DW, Kim YM, Mo JH, Choi HG, Park JW, Shin HW Abstract This corrects the article on p. 691 in vol. 11, PMID: 31332980. PMID: 32400139 [PubMed - in process]
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
CONCLUSIONS: Production of mtROS, disrupted mitochondrial function, and structural changes in nasal epithelial cells might be involved in the pathogenesis of CRSwNP. PMID: 32400131 [PubMed]
Source: Allergy, Asthma and Immunology Research - Category: Allergy & Immunology Tags: Allergy Asthma Immunol Res Source Type: research
A patient with severe CRSwNP, asthma, and NSAIDS received dupilumab treatment. Three weeks after therapy onset, the patient was diagnosed with Covid-19, had a mild course of the disease, and fully recovered from the infection.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
CONCLUSIONS: Based on simple approach of nasal secretions sampling, we showed that a predominant T helper 2 proteins expression profile can be associated with recurrent CRSwNP after ESS. Initial immunoprofiling in CRSwNP disease may contribute to better predict the therapeutic response to optimal medical and surgical treatment, and help define the role of innovative targeted treatment, beside corticosteroids and ESS. PMID: 32369537 [PubMed - as supplied by publisher]
Source: Rhinology - Category: ENT & OMF Tags: Rhinology Source Type: research
Chronic rhinosinusitis (CRS) describes an inflammatory condition affecting the sinonasal mucosa. As the immune system players such as immunoglobulins play prominent roles in the development of CRS, we aimed to...
Source: Allergy, Asthma and Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Research Source Type: research
AbstractPurpose of ReviewChronic rhinosinusitis with nasal polyps (CRSwNP) is a highly prevalent disease that results in significant healthcare-related costs as well as costs to society with lost productivity and time. Unfortunately, a significant percentage of patients who suffer with this disease will not find relief from current standard of care medications and surgery. With ongoing efforts to understand the pathophysiology of CRSwNP has come the introduction of monoclonal antibodies, or “biologics,” targeting specific elements of the inflammatory pathway in CRSwNP. Despite efficacy, these come at significan...
Source: Current Allergy and Asthma Reports - Category: Allergy & Immunology Source Type: research
Abstract BACKGROUND: Blood eosinophil count measurements are a noninvasive, relatively reliable surrogate marker for eosinophilic airway inflammation. Single measurements of peripheral blood eosinophil counts ≥150 cells/μL predict response to anti-eosinophil therapies for patients with characteristics of severe eosinophilic asthma. OBJECTIVE: To describe how blood eosinophil counts shift over time for patients with severe, uncontrolled asthma receiving placebo in two large randomized, placebocontrolled clinical trials of benralizumab (SIROCCO and CALIMA). METHODS: Our analysis included adult patien...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Ann Allergy Asthma Immunol Source Type: research
This study aims to evaluate how asthma influences clinical symptoms, imaging scores and HRQL in CRS patients.Methods: The study enrolled CRS patients and collected data about asthma status, clinical symptoms, allergic sensitization, computed tomography (CT) and 22-item SinoNasal Outcome questionnaire (SNOT-22). Matching pairs of asthmatic and non-asthmatic CRS patients were defined based on age, gender and nasal polyp presence. The difference between pairs in clinical symptoms, CT and SNOT-22 was then analyzed. The study enrolled mild to moderate asthma patients.Results: From 250 CRS patients, 65 (26%) had had asthma. We f...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
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