â€œWith the development of monoclonal antibodies that neutralize specific cytokines and the aid of biomarkers, new avenues for the treatment of asthma have been explored.â€
Despite caveats, exceptions, and a need for more information, researchers are enthusiastic about reslizumab, a treatment for patients with uncontrolled asthma who have exhausted other possibilities. A review conducted by Diego Jose Maselli, MD, of the Department of Medicine in the Division of Pulmonary Diseases and Critical Care at the University of Texas Health Science Center at San Antonio and colleagues examined the data on reslizumab. The review was published in the Journal of Asthma and Allergy recently.
The reviewers begin by explaining that in the last 20 years, new targeted therapies have been a subject of intense interest. They say that “With the development of monoclonal antibodies that neutralize specific cytokines and the aid of biomarkers, new avenues for the treatment of asthma have been explored.”
“One such therapy,” they explain, “is reslizumab, a monoclonal antibody that inhibits interleukin-5 (IL-5).” The Federal Drug Administration (FDA) recently approved reslizumab as an add-on therapy for severely asthmatic adults with an eosinophilic phenotype.
Four studies established the safety of reslizumab, as well as showed that the drug “demonstrated efficacy in treating severe eosinophilic asthma,” say the reviewers, adding that the “approved dosage regimen is 3 mg/kg IV over 20-50 minutes every 4 weeks” for patients who are 18 years or older.
Two other IL-5 inhibitors are discussed in the present review: mepolizumab and benralizumab. Mepolizumab has been approved by the FDA for treatment in patients with asthma who are 12 years and older; benralizumab is currently in phase 3 studies.
“To date, there are no head-to-head trials comparing the efficacy of mepolizumab and reslizumab,” report the reviewers. However, there are some differences clinicians should consider. One is age, another is the fact that mepolizumab is administered subcutaneously while reslizumab requires intravenous administration.
Trials and studies continue and the authors say, “Future surveillance and ‘real-life’ studies will be needed to further confirm the efficacy and safety of reslizumab in the treatment of the eosinophilic asthma phenotype.” They also note that many questions remain regarding how anti-IL-5 agents can be used in clinical practice.
The authors conclude that regardless of remaining questions, “it is an exciting time for both clinicians and patients as increased options for these difficult-to-treat patients are becoming available.”