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The effects of lebrikizumab in patients with mild asthma following whole lung allergen challenge
Author(s) -
Scheerens H.,
Arron J. R.,
Zheng Y.,
Putnam W. S.,
Erickson R. W.,
Choy D. F.,
Harris J. M.,
Lee J.,
Jarjour N. N.,
Matthews J. G.
Publication year - 2014
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12220
Subject(s) - medicine , periostin , asthma , placebo , immunoglobulin e , immunology , gastroenterology , allergy , antibody , pathology , alternative medicine , extracellular matrix , biology , microbiology and biotechnology
Summary Background Interleukin 13 ( IL 13) is a T‐helper type 2 (Th2) cytokine associated with inflammation and pathology in allergic diseases such as bronchial asthma. We have shown that treatment with lebrikizumab, an anti‐ IL 13 monoclonal antibody, significantly improves prebronchodilator forced expiratory volume in 1 s ( FEV 1 ) in a subset of subjects with uncontrolled asthma. Objective To evaluate efficacy and safety of lebrikizumab in subjects with mild asthma who underwent bronchial allergen challenge. Methods Twenty‐nine subjects were randomized 1 : 1–5 mg/kg lebrikizumab ( n = 13) or placebo ( n = 16) administered subcutaneously every 4 weeks over 12 weeks, a total of four doses. Primary efficacy outcome was late asthmatic response (LAR) at Week 13, defined as area under the curve of FEV 1 measured 2–8 h following inhaled allergen challenge. Serum biomarkers were measured to verify IL 13 pathway inhibition and identify patients with an increased response to lebrikizumab. Results At Week 13, the LAR in lebrikizumab subjects was reduced by 48% compared with placebo subjects, although this was not statistically significant (95% confidence interval, −19%, 90%). Exploratory analysis indicated that lebrikizumab‐treated subjects with elevated baseline levels of peripheral blood eosinophils, serum IgE, or periostin exhibited a greater reduction in LAR compared with subjects with lower baseline levels of these biomarkers. Lebrikizumab exerted systemic effects on markers of Th2 inflammation, reducing serum immunoglobulin E (IgE), chemokine ligands 13 and 17 by approximately 25% ( P < 0.01). Lebrikizumab was well tolerated. Conclusion and Clinical Relevance Lebrikizumab reduced the LAR in subjects with mild asthma. Clinical trial number NCT 00781443.