Patients with symptomatic moderate asthma who were treated with anti-tumor necrosis factor alpha, an anti-inflammatory monoclonal antibody, experienced significantly fewer disease exacerbations than individuals taking a placebo.
This research appears in the first issue for October 2006 of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
Trevor T. Hansel, M.D., Ph.D., of the National Heart and Lung Institute at Royal Brompton Hospital in London, and 11 associates infused 14 patients with infliximab, a monoclonal antibody that binds and neutralizes tumor necrosis factor alpha (TNF). Eighteen patients received placebo during the eight-week double-blind study.
According to the investigators, both structured and inflammatory cells in asthmatics can release TNF, which is an intercellular messenger protein, a cytokine, produced by white blood cells.
"Anti-TNF therapy has been shown to be effective in patients with rheumatoid arthritis, ankylosing spondylitis, Crohn's disease and psoriasis, but ineffective in patients with chronic obstructive pulmonary disease (COPD)," said Dr. Hansel. "Preliminary reports of efficacy in asthma patients with concomitant rheumatoid arthritis have been encouraging. Small prospective studies of a soluble receptor directed against TNF in severe refractory asthma have also shown improvements in lung function and airway hyperresponsiveness."
During the study, 13 of the 18 patients on placebo (72 percent) experienced exacerbations, as compared to only four out of 14 patients (29 percent) on infliximab therapy.
All patients in the study cohort continued to use inhaled corticosteroids for their asthma. Study protocol required them to be symptomatic during a two- to four-week run-in period.
After the run-in phase, infusions of either infliximab or placebo were administered at weeks zero, two and six.