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Table 1 FDA approved therapies

From: Potential new targets for drug development in severe asthma

 

Mechanism of Action

Biomarker

Outcomes

Significant Adverse Events

References

Omalizumab

Blocks IgE interaction to FcεRI

↑FeNO (> 19.5 ppb)

↑Peripheral eosinophils (≥200/uL)

Decreased exacerbations

Reduced IgE levels

Improved quality of life

Cardiovascul ar and cerebrovascu lar event risk

Hanania 2013 [6]

Busse 2013 [7]

Casale 2017 [4]

Chipps 2017 [9]

Mepolizumab

Anti-IL5

↑Peripheral eosinophils (> 150 or 300/uL) or sputum eosinophilia (> 3%)

Decreased exacerbations

Reduced prednisone dose

Decreased blood and sputum eosinophils

Improved quality of life

Herpes Zoster; Helminth infections

Nair 2009 [10]

Pavord 2012 [11]

Liu 2013 [14]

Ortega 2014 [13]

Bel 2014 [12]

Reslizumab

Anti-IL5

↑Peripheral eosinophils (> 400/uL) or sputum eosinophilia (> 3%)

Decreased exacerbations

Decreased blood and sputum eosinophils

Improved FEV1

Helminth infections; CPK elevation

Castro 2011 [15]

Castro 2015 [16]

Corren 2016 [17]

Benralizumab

Anti-IL5Ralpha

↑Eosinophils

↑FeNO

Decreased exacerbations (higher eosinophilia more predictive of response)

Improved FEV1

Helminth infections

Castro 2014 [18]

FitzGerald 2016 [19]

Bleecker 2016 [20]