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.

—Leigh Precopio

Reference:

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