Depemokimab: A Breakthrough in Long-Lasting Asthma Treatment

Thu 27th Mar, 2025
Asthma affects an estimated 42 million individuals across Europe, posing significant health challenges. Interleukin-5 (IL-5) is a crucial cytokine implicated in Type 2 inflammation, which can be identified through eosinophil counts in the blood. This type of inflammation is prevalent among patients suffering from severe asthma and can lead to exacerbations and hospital admissions. Moreover, up to 80% of individuals with chronic rhinosinusitis with nasal polyps (CRSwNP) also exhibit Type 2 inflammation. Currently, several monoclonal antibodies targeting IL-5 or its receptor are available for the treatment of severe eosinophilic asthma. These include mepolizumab, reslizumab, and benralizumab, which are approved as add-on therapies. Mepolizumab is additionally indicated for treating CRSwNP. Depemokimab, a novel treatment, differs from mepolizumab due to specific modifications in its amino acid sequence. These alterations enhance the antibody's binding affinity to IL-5 and provide increased attachment to the neonatal Fc receptor (FcRn). This intracellular receptor plays a role in recycling IgG antibodies, thereby preventing their degradation. As a result, Depemokimab is protected from lysosomal breakdown, extending its half-life. The combination of heightened IL-5 affinity and prolonged half-life enables effective IL-5 blockade with just two injections per year. The European Medicines Agency (EMA) is currently reviewing Depemokimab for approval as an adjunct therapy for maintaining asthma control in adolescents and adults aged 12 years and older who exhibit Type 2 inflammation characterized by an eosinophilic phenotype. This is specifically for patients inadequately controlled on medium- to high-dose corticosteroids along with another asthma management medication. Additionally, the drug is being evaluated as an add-on therapy for adults with poorly controlled CRSwNP. If approved, Depemokimab would be the first ultra-long-acting biologic requiring administration only every six months. The applications for regulatory approval are supported by findings from the SWIFT and ANCHOR studies. The SWIFT-1 and SWIFT-2 trials demonstrated that Depemokimab significantly reduced exacerbation rates and hospitalizations among asthma patients with Type 2 inflammation. The results were published in a prestigious medical journal, underscoring the drug's potential. Similarly, the ANCHOR-1 and ANCHOR-2 trials revealed that Depemokimab effectively decreased the size and obstruction of nasal polyps compared to placebo, with findings recently published in a leading medical periodical. Beyond asthma and CRSwNP, Depemokimab is undergoing Phase III trials for other IL-5-mediated conditions, including eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES). This interest in expanding the treatment's applications is not surprising, as mepolizumab is already approved for EGPA and HES, while benralizumab has been authorized for use in EGPA. As researchers continue to explore the full potential of Depemokimab, its promise as a long-lasting treatment option for asthma and related conditions remains a focus of great interest within the medical community.

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