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The Ethics of Pharmaceutical Companies in the Treatment of Severe Asthma

The Ethics of Pharmaceutical Companies in the Treatment of Severe Asthma

Dupilumab is close to entering the market to treat moderate to severe asthma patients. The editorial of NEJM asks for ethic clinical trials from pharmaceutical companies so that all patients can benefit from new treatments.

The New England Journal of Medicine dedicates this week’s editorial to the treatment options for asthma patients. To coincide with this week’s meeting of the American Thoracic Society, the journal published a series of articles about respiratory conditions; two of those articles focus on Dupilumab, a monoclonal antibody that inhibits the action of IL-4 and IL-13. These two small proteins play a crucial role in shaping the immune system and mediate the allergic and inflammatory responses in several respiratory diseases, asthma included.

Dupilumab is likely joining the list of biologics – which, among other characteristics, are grown and extracted from cell cultures and are highly specific for their target molecules – used to treat asthma. The addition of Dupilumab to the biologics list might be an advance for the field. But, as the authors of the editorial, Jeffrey M. Drazen and David Harrington, argue, “progress still falls short of the desired goal” for patients with severe asthma. While the clinical trials show good results for some of these patients, others see no clinical improvements with Dupilumab. Drazen and Harrington ask for more research into finding new biological markers of the disease, and for more “pragmatic, head-to-head trials” with the new biologics available. Only then severe asthma patients can be treated with more precision.

The authors point that even when new markers are researched and found, the treatment decisions are still in the hands of the pharmaceutical companies that sell those treatments. Drazen and Harrington finish by saying that without new data and ethically driven pharmaceutical decisions, “we will end up prescribing the most effective marketing. Our patients deserve better than that”, they conclude.

Read the editorial here: New Biologics For Asthma.
Read the article: Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma
Read the articleDupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma
[The two mentioned studies were supported by the pharmaceutical companies Sanofi and Regeneron, which sell dupilumab under the trade name Dupixent]

Image Credit: Mikael HäggströmOwn work, CC0, Link