Biologics for atopic diseases: Indication, side effect management, and new developments

Jappe, Uta; Beckert, Hendrik; Bergmann, Karl‐Christian; Gülşen, Aşkın; Klimek, Ludger; Philipp, Sandra; Pickert, Julia; Rauber-Ellinghaus, Michèle M; Renz, Harald; Taube, Christian; Treudler, Regina; Wagenmann, Martin; Werfel, Thomas; Worm, Margitta; Zuberbier, Torsten

doi:10.5414/alx02197e

Cited by 16 publications

(19 citation statements)

References 155 publications

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“…Claims of effectiveness have been made based largely on observational studies, descriptive reviews or small clinical trials 7–10 . These therapies can be costly and can be burdensome for patients, so we wanted to compile the most robust research about biologicals to inform Global Allergy and Asthma European Network (GA 2 LEN) guidelines 11 .…”

Section: Introductionmentioning

confidence: 99%

Systematic review of monotherapy with biologicals for children and adults with IgE‐mediated food allergy

Silva¹,

Singh²,

Arasi

et al. 2022

Clinical & Translational All

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Background Biological therapies relieve symptoms in allergic inflammatory diseases so we systematically reviewed the evidence about whether biological monotherapy could benefit people with IgE‐mediated food allergy. Methods We searched six bibliographic databases from 1946 to 30 September 2021 for randomised and non‐randomised controlled trials about biological monotherapy in people with IgE‐mediated food allergy confirmed by oral food challenge. We used the Grading of Recommendations, Assessment, Development and Evaluation approach to narratively summarise findings from three trials with 118 participants. The studies were too heterogeneous and sparse to conduct meta‐analysis. Results We included one randomised trial about etokimab, one about omalizumab and one about the discontinued TNX‐901. All were in people with peanut allergy in the USA, mostly aged 13+ years. There was a trend towards improved tolerance of peanut during treatment, with few side effects. However, we have very low certainty about the evidence due to the small number of trials and participants. No included trial reported on quality of life or cost‐effectiveness. Conclusions There is not yet enough certainty to support offering etokimab or omalizumab widely for food allergy. Clinicians may consider the merits for individuals, but large randomised trials with standardised measures are needed to confirm the safety, efficacy and most suitable candidates, doses and durations of treatment before more universal use.

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Section: Introductionmentioning

confidence: 99%

Systematic review of monotherapy with biologicals for children and adults with IgE‐mediated food allergy

Silva¹,

Singh²,

Arasi

et al. 2022

Clinical & Translational All

Self Cite

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“…It is worth emphasizing that the studies published to date do not indicate an increased risk of SARS-CoV-2 infection in patients using biological drugs for psoriasis and atopic dermatitis [ 16 , 17 , 20 , 23 , 27 ]. In light of the ongoing SARS-CoV-2 pandemic, two meta-analyses of the incidence of upper respiratory tract infections (other than COVID-19) during treatment with dupilumab showed that, in controlled studies, there was no increase in systemic infections with antibody therapy [ 34 ]. The authors suggest that biological treatment should not be suspended during COVID-19 [ 25 ], as a treatment interruption could significantly exacerbate the underlying disease and result in hospitalization [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of SARS-CoV-2 Virus Infection on the Course of Atopic Dermatitis in Patients

et al. 2021

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Background and Objectives: Atopic dermatitis (AD) is a disease with a complex pathophysiology involving immune-mediated reactions that lead to skin lesions that are typically localized and recurrent. Following the outbreak of the COVID-19 (coronavirus disease 2019) pandemic, attempting to assess the impact of SARS-CoV-2 infection on diseases caused by complex immune mechanisms has become important. The aim of this study was to assess the impact of SARS-CoV-2 infection on the course of AD, including immunosuppressive therapy, in patients with a severe form of the disease. Materials and Methods: A retrospective analysis of 21 adults aged 18 to 52 years with AD diagnosed with COVID-19, including patients requiring hospitalization, was performed. Results: During SARS-CoV-2 infection, temporary exacerbation of skin lesions and/or skin pruritus was observed in nine (43%) patients but without the need for systemic treatment intervention. Patients with severe AD who received immunosuppressive therapy most often manifested mild exacerbation of skin symptoms. The skin condition improved in three patients. There was no significant effect of disease severity on the risk of severe COVID-19 (HR = 0.45; 95% CI: 0.32–0.65). Conclusions: The course of atopic dermatitis during SARS-CoV-2 infection may be different from the severity of its symptoms due to the lack of a significant influence. The immunosuppressive treatment used in patients with severe AD did not significantly affect the course of SARS-CoV-2 infection.

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“…This insight and the clinically challenging problem of polyp recurrence and symptom persistence have been the most important drivers to introduce biologicals into the treatment paradigm for CRSwNP. Positive results in phase 3 studies with the IL4Rα blocking antibody dupilumab [ 108 ] and the anti IgE-antibody omalizumab [ 109 ] have now led to its approval in many countries [ 110 ]. Similar studies with mepolizumab (anti-IL-5), and benralizumab (anti-IL-5R) are either ongoing or not yet published.…”

Section: Methodsmentioning

confidence: 99%

“…Upper airway diseases Compounds of the type 2 inflammation in chronic rhinosinusitis with nasal polyps (CRSwNP) have been characterized and led to new forms of biological treatment options. [ 110 ] …”

Section: Conflict Of Interestmentioning

confidence: 99%

Precision medicine reaching out to the patients in allergology – a German-Japanese workshop report

Pfaar

Blümchen

Boateng

et al. 2021

ALS

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An expert workshop in collaboration of the German Society of Allergy and Clinical Immunology (DGAKI) and the Japanese Society of Allergy (JSA) provided a platform for key opinion leaders of both countries aimed to join expertise and to highlight current developments and achievements in allergy research. Key domains of the meeting included the following seven main sections and related subchapters: 1) basic immunology, 2) bronchial asthma, 3) prevention of allergic diseases, 4) food allergy and anaphylaxis, 5) atopic dermatitis, 6) venom allergy, and 7) upper airway diseases. This report provides a summary of panel discussions of all seven domains and highlights unmet needs and project possibilities of enhanced collaborations of scientific projects.

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Biologics for atopic diseases: Indication, side effect management, and new developments

Cited by 16 publications

References 155 publications

Systematic review of monotherapy with biologicals for children and adults with IgE‐mediated food allergy

Systematic review of monotherapy with biologicals for children and adults with IgE‐mediated food allergy

The Effect of SARS-CoV-2 Virus Infection on the Course of Atopic Dermatitis in Patients

Precision medicine reaching out to the patients in allergology – a German-Japanese workshop report

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