The new indications for biologicals in type 2 diseases: perspectives

Bagnasco, Diego; Canevari, Rikki Frank; Passalacqua, Giovanni; Caminati, Marco

doi:10.1097/aci.0000000000000862

Cited by 2 publications

(3 citation statements)

References 84 publications

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“…Again, observations in real life have shown the efficacy of the drug in other diseases such as eosinophilic esophagitis [ 67 , 68 , 69 ]. Mepolizumab was approved for two orphan diseases, namely, EGPA [ 70 , 71 , 72 ] and HES [ 73 , 74 , 75 ].…”

Section: T2 Targeted Therapies In Asthmamentioning

confidence: 99%

Personalized and Precision Medicine in Asthma and Eosinophilic Esophagitis: The Role of T2 Target Therapy

Bagnasco,

Savarino,

Yacoub

et al. 2023

Pharmaceutics

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The role of type 2 inflammation has been progressively associated with many diseases, including severe asthma, atopic dermatitis, nasal polyposis, eosinophilic granulomatosis with polyangiitis, and, recently, eosinophilic esophagitis. Despite this, the association between asthma and esophagitis is still poorly known, and this is probably because of the low prevalence of each disease and the even lower association between them. Nonetheless, observations in clinical trials and, subsequently, in real life, have allowed researchers to observe how drugs acting on type 2 inflammation, initially developed and marketed for severe asthma, could be effective also in treating eosinophilic esophagitis. For this reason, clinical trials specifically designed for the use of drugs targeted to type 2 inflammation were also developed for eosinophilic esophagitis. The results of clinical trials are presently promising and envisage the use of biologicals that are also likely to be employed in the field of gastroenterology in the near future. This review focuses on the use of biologicals for type 2 inflammation in cases of combined severe asthma and eosinophilic esophagitis.

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Section: T2 Targeted Therapies In Asthmamentioning

confidence: 99%

Personalized and Precision Medicine in Asthma and Eosinophilic Esophagitis: The Role of T2 Target Therapy

Bagnasco,

Savarino,

Yacoub

et al. 2023

Pharmaceutics

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“…As mentioned in the previous paragraph, especially in the acute vasculitis phase, the Th1/17 mediated cascade and the autoimmune B-cell derived autoantibodies driven components coexist with eosinophilic inflammation [1,7 ▪ ]. However, targeting eosinophils has been successfully explored in the last few years as a treatment option for EGPA patients [4 ▪ ] (Fig. 1).…”

Section: Overview On Marketed “Anti T2” Monoclonal Antibodies and Rat...mentioning

confidence: 99%

“…The opportunity to explore the relevance of targeted therapies, well known in the field of severe asthma, and addressing T2 inflammation drivers represents a definitely new frontier in the EGPA treatment armamentarium. Due to their optimal safety and tolerability profile, monoclonal antibodies targeting eosinophils are very promising as the cornerstone of EGPA treatment [3 ▪ ,4 ▪ ]. However, some controversial aspects still need to be explored and their ability to interfere with vasculitis pathogenesis and clinical manifestations remains unclear…”

Section: Introductionmentioning

confidence: 99%

Biologics for eosinophilic granulomatosis with polyangiitis

Caminati

Maule

Bello

et al. 2022

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewThe link between severe asthma and eosinophilic granulomatosis with polyangiitis (EGPA) in terms of pathophysiological background, clinical manifestations and disease evolution has leaded to investigate the relevance of anti T2 monoclonal antibodies licensed for severe asthma patients as a treatment option for EGPA. The present review aimed to provide un update on EGPA pathophysiology and to critically summarize the most robust evidence coming from trials and real-life setting on the use of anti T2 biologics in EGPA patients.Recent findingsMepolizumab, an anti-interleukin-5 monoclonal antibody, is the only biologic drug targeting eosinophilic inflammation currently approved for EGPA treatment at the dose of 300 mg/4 weeks. Its use is restricted by the American College of Rheumatology guidelines to specific diseases phases and severity grades. However the most appropriate mepolizumab positioning and dose is still under investigation in the real life practice, which is providing an increasing amount of evidence confirming its efficacy, alone or in combination with other options in different disease stages. The relevance of other monoclonal antibodies interfering with T2 inflammation, including omalizumab and benralizumab, is under investigation but the evidence is still scarceSummaryTaking into account the suboptimal medium-long term safety profile of conventional EGPA treatments, the opportunity of selectively targeting eosinophilic inflammation certainly represents a revolutionary approach. However, further real-word evidence is required to effectively position the new treatments in the light of the disease complexity, including different immunological drivers, and individual variability.

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The new indications for biologicals in type 2 diseases: perspectives

Cited by 2 publications

References 84 publications

Personalized and Precision Medicine in Asthma and Eosinophilic Esophagitis: The Role of T2 Target Therapy

Personalized and Precision Medicine in Asthma and Eosinophilic Esophagitis: The Role of T2 Target Therapy

Biologics for eosinophilic granulomatosis with polyangiitis

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