Impact of reslizumab on outcomes of severe asthmatic patients: current perspectives

Abstract

Alicia Padilla Galo,1,* Marina Labor,2,3,* Angelica Tiotiu,4 Ilaria Baiardini,5 Nicola Scichilone,6 Fulvio Braido7 1Unit of Pneumology, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain; 2Department of Pulmonology, University Hospital Center Osijek, Osijek, Croatia; 3Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia; 4Department of Pulmonology, CHRU Nancy, DevAH – Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, University of Lorraine, Nancy, France; 5Department of Biomedical Sciences, Humanitas University, Milan, Italy; 6Department of Biomedicine and Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Palermo, Italy; 7Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova – Azienda Policlinico IRCCs San Martino, Genova, Italy *These authors contributed equally to this work Abstract: Approximately 5%–10% of asthmatics suffer from severe asthma. New biological treatments represent a great opportunity to reduce asthma burden and to improve asthma patients’ lives. Reslizumab will soon be available in several European countries. This anti-IL-5 IgG4/κ monoclonal antibody, administered intravenously at a dose of 3 mg/kg over 20–50 minutes every 4 weeks, has been shown to be safe and effective in patients with 400 eosinophils/μL or more in their peripheral blood. The clinical effects in reducing asthma exacerbations and in improving the quality of life and lung function are clear, but further research is needed to determine the best biological compound for a specific cluster of patients. Research data have shown that in patients who were expressing other clinical features of eosinophilic inflammation over asthma (rhinosinusitis and nasal polyposis), the clinical benefit of reslizumab was greater. Furthermore, it has also been observed that in patients with unsatisfactory response to mepolizumab, reslizumab is able to significantly improve the clinical and biological parameters. The aim of personalized medicine is to provide the right drug to the right patient at the right dose at the right moment. The biological treatments that were developed to modify specific pathological pathways not only provide us with the tools for the management of asthma patients but also clarify the biological mechanisms involved in its pathogenesis. Keywords: asthma, patient-reported outcomes, personalized medicine, reslizuma