Unita Operativa Complessa di Pneumologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Università Cattolica del Sacro Cuore, Rome, Italy.
Unita Operativa Complessa di Pneumologia, Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione policlinico universitario "A. Gemelli" IRCCS, Rome, Italy.
Expert Opin Biol Ther. 2023 Jul-Dec;23(12):1239-1244. doi: 10.1080/14712598.2023.2268014. Epub 2023 Dec 28.
The use of pirfenidone and nintedanib in treating Idiopathic Pulmonary Fibrosis (IPF) has shown significant slowing down of the progressive functional decline in these patients. In recent times, antibody-based therapies with precise molecular targets have also been explored as alternative treatments to IPF.
This review aims to summarize the available updates regarding monoclonal antibodies that have been tested in IPF. The drugs describedare developed to antagonize inflammation,immunity pathways and fibrogenesis. Currently, the anti-CTGF pamrevlumab has demonstrated a significant reduction in functional decline as compared to placebo and is undergoing the last stages of phase 3 trial.
Although antibody-based therapies for IPF have had unsatisfactory results in most trials in the last few years, the pursuit of therapeutic development in this field should continue to deliver a more personalized treatment approach in the future, which is currently not available with existing treatment options. However, several molecules are still under study and some have shown encouraging results in the early phases of clinical trials. Future investigations need to be more carefully designed and valid predictive markers of response to treatment should be used to enhance the effectiveness of future trials.
吡非尼酮和尼达尼布在治疗特发性肺纤维化（IPF）中的应用已显示出显著减缓这些患者进行性功能下降的作用。最近，基于抗体的、具有精确分子靶点的治疗方法也被探索作为 IPF 的替代治疗方法。
本综述旨在总结已在 IPF 中进行测试的单克隆抗体的最新进展。这些描述的药物是为了拮抗炎症、免疫途径和纤维化发生而开发的。目前，与安慰剂相比，抗 CTGF 的 pamrevlumab 已显示出在功能下降方面的显著减少，并且正在进行第 3 阶段试验的最后阶段。
尽管近年来大多数试验中抗体治疗 IPF 的结果并不令人满意，但在该领域继续追求治疗开发，应该有助于在未来提供更个性化的治疗方法，而目前现有的治疗方法无法实现这一点。然而，仍有几种分子在研究中，一些在临床试验的早期阶段显示出令人鼓舞的结果。未来的研究需要更仔细地设计，并应使用有效的治疗反应预测标志物来提高未来试验的有效性。
