Fevipiprant in the treatment of asthma

ABSTRACT

Introduction: Asthma is common and in many, particularly those with more severe disease, there remains a substantial unmet need. Success with biologics targeting eosinophilic inflammation underscore the value of treating inflammation in asthma beyond corticosteroids. Fevipiprant (QAW039) is an oral treatment for asthma. It competitively and reversibly antagonises the prostaglandin D2 receptor 2 (DP2) expressed on inflammatory and structural cells.

Areas covered: We reviewed fevipiprant’s mode of action and efficacy against other current and emerging pharmacological interventions for moderate-to-severe asthma. We undertook a literature review using the PubMed/Medline database, the U.S. National Library of Medicine’s Clinical Trials website and from manufacturers’ press releases with the search terms: ‘QAW039’, ‘Fevipiprant’, ‘CRTH2 antagonists’, ‘DP2’, ‘DP1’, ‘monoclonal antibody’, ‘eosinophil’ with ‘asthma’ plus the names of individual drugs. Three Phase 2 trials have been conducted and three Phase 3 trials (NCT02563067, NCT03052517, NCT02555683) are in progress. To date Fevipiprant’s greatest success has been in targeting severe eosinophilic asthma.

Expert opinion: Fevipiprant presents the possibility of a new orally active therapy for asthma. If successful in phase 3 trials it will have an enormous impact on the treatment paradigm for asthma and will potentially widen access for pre-biologic treatment to a larger population.

KEYWORDS:

• Asthma
• fevipiprant
• mepolizumab
• reslizumab
• omalizumab
• eosinophil
• inflammation

Box 1. Drug summary box.

Declaration of interest

C. Brightling has received research grants and consiltancy fees paid to his institution from AZ MedImmune, GlaxoSmithKline, Novartis, Chiesi, Pfizer, Merck, Vectura, Roche, PreP, Genentech, Boehringer Ingleheim, Theravance, Gilead, Glenmark and TEVA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

A reviewer on this manuscript has disclosed that in the last 5 years they have received speaker’s honoraria for speaking at sponsored meetings from Astra Zeneca, Boehringer Inglehiem, Aerocrine, Almirall, Novartis, Teva, Chiesi and GSK and a payment for organising an educational event from AZ and Teva. They have also received honoraria for attending advisory panels with Almirall, Genentech, Regeneron, Astra Zeneca, Boehringer Ingelheim, GSK, MSD, Schering-Plough, Novartis, Dey, Napp, Teva, Merck, Sanofi, Circassia, Chiesi, Knopp, Regeneron and Respivert. They have also received sponsorship to attend international scientific meetings from Boehringer Ingelheim, GSK, Astra Zeneca, Teva, Chiesi and Napp. He has received a grant from Chieisi to support a phase 2 clinical trial in Oxford.

Additional information

Funding

This paper was not funded.