Abstract
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease associated with significant morbidity and mortality. Current diagnostic criteria based on the presence of fixed airflow obstruction and symptoms do not integrate the complex pathological changes occurring within the lung and they do not define different airway inflammatory patterns. The current management of COPD is based on 'one size fits all' approach and does not take the importance of heterogeneity in COPD population into account. The available treatments aim to alleviate symptoms and reduce exacerbation frequency but do not alter the course of the disease. Recent advances in molecular biology have furthered our understanding of inflammatory pathways in pathogenesis of COPD and have led to development of targeted therapies (biologics and small molecules) based on predefined biomarkers. Herein we shall review the trials of biologics in COPD and potential future drug developments in the field.
Keywords:
COPD; TSLP; anti-IL1β, IL33, IL13; anti-IL5; anti-IL8; anti-TNFα; benralizumab; biologics; eosinophil; mepolizumab.
MeSH terms
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Airway Remodeling / immunology
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Antibodies, Monoclonal, Humanized / therapeutic use
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Biological Products / therapeutic use*
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Eosinophils / immunology
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Etanercept / therapeutic use
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Humans
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Infliximab / therapeutic use
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Interleukin-1 / antagonists & inhibitors
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Interleukin-1 / immunology
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Interleukin-13 / antagonists & inhibitors
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Interleukin-13 / immunology
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Interleukin-5 / antagonists & inhibitors
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Interleukin-5 / immunology
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Interleukin-8 / antagonists & inhibitors
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Interleukin-8 / immunology
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Molecular Targeted Therapy
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Pulmonary Disease, Chronic Obstructive / drug therapy*
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Pulmonary Disease, Chronic Obstructive / immunology
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Pyrimidines / therapeutic use
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Receptors, Interleukin-1 Type I / antagonists & inhibitors
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Receptors, Interleukin-1 Type I / immunology
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Receptors, Interleukin-5 / antagonists & inhibitors
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Receptors, Interleukin-5 / immunology
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Receptors, Interleukin-8B / antagonists & inhibitors
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Receptors, Interleukin-8B / immunology
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Sulfonamides / therapeutic use
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
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Tumor Necrosis Factor-alpha / immunology
Substances
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Antibodies, Monoclonal, Humanized
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Biological Products
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Interleukin-1
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Interleukin-13
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Interleukin-5
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Interleukin-8
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N-(2-(2,3-difluoro-6-benzylthio)-6-(3,4-dihydroxybutan-2-yloxy)pyrimidin-4-yl)azetidine-1-sulfonamide
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Pyrimidines
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Receptors, Interleukin-1 Type I
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Receptors, Interleukin-5
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Receptors, Interleukin-8B
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Sulfonamides
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Tumor Necrosis Factor-alpha
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benralizumab
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mepolizumab
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Infliximab
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Etanercept