Novel approaches to the management of noneosinophilic asthma

Thomson, Neil C.

doi:10.1177/1753465816632638

Cited by 94 publications

(92 citation statements)

References 213 publications

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“…This disease has been traditionally associated with the type 2 cytokines IL-4, IL-5, and IL-13, which promote immunoglobulin class switching to IgE, eosinophilia, and AHR, respectively (2,3). However, approximately half of patients with asthma have a noneosinophilic form of this disease, many with predominantly neutrophilic inflammation of the airway (4,5). Unfortunately, these patients respond very poorly to inhaled corticosteroids, the gold standard asthma therapy (6), and there is a need for novel therapeutic approaches.…”

Section: Introductionmentioning

confidence: 99%

TNF is required for TLR ligand–mediated but not protease-mediated allergic airway inflammation

Whitehead¹,

Thomas²,

Shalaby³

et al. 2017

Journal of Clinical Investigation

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Section: Introductionmentioning

confidence: 99%

TNF is required for TLR ligand–mediated but not protease-mediated allergic airway inflammation

Whitehead¹,

Thomas²,

Shalaby³

et al. 2017

Journal of Clinical Investigation

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“…Currently, no other drug, especially no biologic, is known to target this asthma phenotype. The results of clinical trials of biologics targeting mediators associated with non‐eosinophilic inflammation, such as IL‐17 and tumor necrosis factor (TNF)‐α, are disappointing …”

Section: Other Biologics Which Could Be Of Interest In Children With mentioning

confidence: 99%

New perspectives of childhood asthma treatment with biologics

Just

Deschildre

Lejeune

et al. 2018

Pediatric Allergy Immunology

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Asthma is no longer considered as a single disease but rather as a syndrome corresponding to different entities and pathophysiologic pathways. A targeted strategy is part of personalized medicine which aims to better define each patient's phenotype and endotype so as to prescribe the most suitable treatment at an individual level. Omalizumab and, more recently, mepolizumab are the first biologics approved for children (6‐18 years). Omalizumab is now widely used to treat severe allergic asthma in children and is highly effective for asthma exacerbations and asthma control with a good safety profile. Moreover, several other drugs—lebrikizumab, dupilumab, tezepelumab, mepolizumab, reslizumab, benralizumab—are used or are being studied in both teenagers and adults and could benefit younger children in the near future. We hypothesize that defining the asthma phenotype/endotype regarding the type and intensity of inflammation, association with allergic or non‐allergic comorbidities, and airway remodeling should contribute to the choice of a specific biologic. Pediatric specificities have to be addressed and validated by studies in children. Long‐term effectiveness and particularly the impact on the natural history of asthma should also be investigated. Severe asthma in children is a complex disease, and patients have to be referred to a specialized pediatric asthma center to confirm diagnosis and initiate the best treatment strategy which could include biologics while taking into account their high cost.

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“…Neutrophilic airway inflammation is found in some patients with asthma although the role of neutrophils in the pathogenesis of asthma is uncertain 58 . A phase II study found that the 4-weeks treatment with CXCR2 antagonist SCH527123 reduced sputum neutrophil percentage by 36.3% in patients with severe asthma and sputum neutrophils > 40%.…”

Section: Cxcr2 Antagonistsmentioning

confidence: 99%

New and developing non-adrenoreceptor small molecule drugs for the treatment of asthma

Thomson

2017

Expert Opinion on Pharmacotherapy

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IntroductionInhaled corticosteroids (ICS) alone or in combination with an inhaled long-acting beta2-agonist (LABA) are the preferred long-term treatment for adults and adolescents with symptomatic asthma. Additional drugs include leukotriene-receptor antagonists, slow-release theophylline and the long-acting muscarinic antagonist (LAMA) tiotropium (approved in 2015). There is a need for more effective therapies, as many patients continue to have poorly controlled asthma. Areas coveredNew and developing long-acting non-adrenoreceptor synthetic drugs for the treatment of symptomatic chronic asthma despite treatment with an ICS alone or combined with a LABA.Data was reviewed from studies published up until November 2016. Expert opinionTiotropium improves lung function and has a modest effect in reducing exacerbations when

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Novel approaches to the management of noneosinophilic asthma

Abstract: Noneosinophilic airway inflammation occurs in approximately 50% of patients with asthma.

Cited by 94 publications

References 213 publications

TNF is required for TLR ligand–mediated but not protease-mediated allergic airway inflammation

TNF is required for TLR ligand–mediated but not protease-mediated allergic airway inflammation

New perspectives of childhood asthma treatment with biologics

New and developing non-adrenoreceptor small molecule drugs for the treatment of asthma

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