AI Article Synopsis
- Lebrikizumab, an anti-IL-13 monoclonal antibody, was evaluated in the CLAVIER study for its effects on airway inflammation and remodeling in patients with moderate-to-severe uncontrolled asthma.
- The study involved a randomized double-blind treatment of 31 patients receiving lebrikizumab and 33 receiving a placebo, assessing changes in eosinophil levels and airway characteristics before and after 12 weeks.
- Results showed that while lebrikizumab did not significantly reduce subepithelial eosinophil counts, it led to improved lung function, reduced subepithelial collagen thickness, and was well-tolerated by patients.
Article Abstract
Background: The anti-interleukin 13 (IL-13) monoclonal antibody lebrikizumab improves lung function in patients with moderate-to-severe uncontrolled asthma, but its effects on airway inflammation and remodelling are unknown. CLAVIER was designed to assess lebrikizumab's effect on eosinophilic inflammation and remodelling.
Objective: To report safety and efficacy results from enrolled participants with available data from CLAVIER.
Methods: We performed bronchoscopy on patients with uncontrolled asthma before and after 12 weeks of randomized double-blinded treatment with lebrikizumab (n = 31) or placebo (n = 33). The pre-specified primary end-point was relative change in airway subepithelial eosinophils per mm of basement membrane (cells/mm ). Pre-specified secondary and exploratory outcomes included change in IL-13-associated biomarkers and measures of airway remodelling.
Results: There was a baseline imbalance in tissue eosinophils and high variability between treatment groups. There was no discernible change in adjusted mean subepithelial eosinophils/mm in response to lebrikizumab (95% CI, -82.5%, 97.5%). As previously observed, FEV increased after lebrikizumab treatment. Moreover, subepithelial collagen thickness decreased 21.5% after lebrikizumab treatment (95% CI, -32.9%, -10.2%), and fractional exhaled nitric oxide, CCL26 and SERPINB2 mRNA expression in bronchial tissues also reduced. Lebrikizumab was well tolerated, with a safety profile consistent with other lebrikizumab asthma studies.
Conclusions & Clinical Relevance: We did not observe reduced tissue eosinophil numbers in association with lebrikizumab treatment. However, in pre-specified exploratory analyses, lebrikizumab treatment was associated with reduced degree of subepithelial fibrosis, a feature of airway remodelling, as well as improved lung function and reduced key pharmacodynamic biomarkers in bronchial tissues. These results reinforce the importance of IL-13 in airway pathobiology and suggest that neutralization of IL-13 may reduce asthmatic airway remodelling.
Clinical Trial Registration: NCT02099656.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756263 | PMC |
| http://dx.doi.org/10.1111/cea.13731 | DOI Listing |
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