Unita Operativa Complessa di Pneumologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione policlinico universitario "A. Gemelli" IRCCS, Rome, Italy.
Unita Operativa Complessa di Pneumologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Università Cattolica del Sacro Cuore, Rome, Italy.
Expert Opin Investig Drugs. 2023 Jan;32(1):17-23. doi: 10.1080/13543784.2023.2173061. Epub 2023 Feb 3.
The two available therapies for idiopathic pulmonary fibrosis (IPF), pirfenidone and nintedanib, slow down but do not halt IPF progression. Therefore, several agents with specific molecular targets have been recently investigated to find a cure for IPF. Phosphodiesterase 4 (PDE4) inhibition is known for its anti-inflammatory and antifibrotic properties. BI 1015550, an oral preferential inhibitor of the isoform PDE4B, could express complementary activity to current therapies in IPF and other forms of progressive pulmonary fibrosis.
In this review, we first provide an overview toof the current IPF treatment market, followed by the description of pharmacokinetics and pharmacodynamics of BI 1015550. The main preclinical and early clinical evidence on BI 1015550 is then described, as well as its potential as an IPF treatment.
Oral treatment with BI 1015550 was shown to stabilize lung function as compared to placebo over 12 weeks, both among patients with and without background antifibrotic use, with an acceptable safety profile in a phase 2 trial, and a phase 3 trial has been initiated. To date, this represents to date the largest effect size for an IPF investigational drug tested in a phase 2 trial with the shortest duration.
特发性肺纤维化 (IPF) 的两种现有治疗方法,吡非尼酮和尼达尼布,可减缓但不能阻止 IPF 的进展。因此,最近研究了几种具有特定分子靶点的药物,以期找到治疗 IPF 的方法。磷酸二酯酶 4 (PDE4) 抑制具有抗炎和抗纤维化特性。BI 1015550 是一种口服的 PDE4B 亚型选择性抑制剂,在 IPF 和其他形式的进行性肺纤维化中可能具有与现有治疗方法互补的作用。
在这篇综述中,我们首先概述了目前的 IPF 治疗市场,接着描述了 BI 1015550 的药代动力学和药效学。然后描述了 BI 1015550 的主要临床前和早期临床证据,以及它作为 IPF 治疗药物的潜力。
在为期 12 周的研究中,与安慰剂相比,口服 BI 1015550 治疗可稳定肺功能,在有背景抗纤维化治疗和无背景抗纤维化治疗的患者中均如此,且在 2 期临床试验中具有可接受的安全性,目前已启动 3 期临床试验。迄今为止,这是在 2 期临床试验中,以最短的研究时间,测试的治疗 IPF 的最大作用药物。