Treatment Challenges in Severe Eosinophilic Asthma: Differential Response to Anti-IL-5 and Anti-IL-5R Therapy

Int J Mol Sci. 2021 Apr 12;22(8):3969. doi: 10.3390/ijms22083969.

Abstract

Severe asthma greatly affects patients' quality of life. Major advances have occurred in the management of severe eosinophilic asthma the past few years due to the new targeted biological therapies. There are three anti-IL-5 mAbs, mepolizumab, reslizumab and benralizumab. Despite the different mechanism of blocking IL-5 the clinical effects are quite similar as randomized controlled trials and real-life studies have shown. Moreover, there are reports of responding to one after failing to respond to another anti-IL-5 therapy. Accordingly, it is challenging to explore the possible differences in the response to anti-IL-5 treatments. This might help us not only understand possible mechanisms that contribute to the resistance to treatment in this particular asthma endotype, but also to phenotype within severe eosinophilic asthma in order to treat our patients more efficiently.

Keywords: anti-IL-5; anti-IL-5R; asthma; benralizumab; mepolizumab; severe eosinophilic asthma.

Publication types

  • Review

MeSH terms

  • Anti-Asthmatic Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Asthma / drug therapy*
  • Asthma / genetics
  • Asthma / pathology
  • Eosinophils / drug effects
  • Eosinophils / pathology
  • Humans
  • Interleukin-5 / antagonists & inhibitors
  • Interleukin-5 / genetics*
  • Receptors, Interleukin-5 / antagonists & inhibitors
  • Receptors, Interleukin-5 / genetics*
  • Signal Transduction / drug effects

Substances

  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • IL5 protein, human
  • Interleukin-5
  • Receptors, Interleukin-5
  • reslizumab
  • benralizumab
  • mepolizumab