Oral immunotherapy with type V collagen in idiopathic pulmonary fibrosis
David S Wilkes, Terrence Chew, Kevin R Flaherty, Sarah Frye, Kevin F Gibson, Naftali Kaminski, Michael J Klemsz, Wade Lange, Imre Noth, Katia Rothhaar, David S Wilkes, Terrence Chew, Kevin R Flaherty, Sarah Frye, Kevin F Gibson, Naftali Kaminski, Michael J Klemsz, Wade Lange, Imre Noth, Katia Rothhaar
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with poor prognosis. IPF appears to be heterogeneous in pathobiology with ∼40% of IPF patients found to have elevated levels of circulating antibodies to the autoantigen type V collagen (col(V)). Following a targeted, precision medicine approach, we conducted a phase 1 study to test the safety and explore potential efficacy of IW001, a col(V) oral immunotherapeutic developed to treat antibody-positive IPF patients. We divided 30 antibody-positive IPF patients into three cohorts for daily dosing over a 24-week period. All patients completed treatment without serious adverse events, acute exacerbations or IPF-related hospitalisations. A decline in lung function occurred in the lowest-dose cohort that was comparable to that reported in placebo arms of published IPF trials. In contrast, the highest-dose cohort showed a trend toward stabilisation of forced vital capacity and matrix metalloproteinase 7, and a reduction in binding of C1q to anti-col(V) antibodies. IW001 may modulate the immune response to col(V) and may represent a new therapeutic for col(V)- reactive IPF patients.
Trial registration: ClinicalTrials.gov NCT00873860.
Copyright ©ERS 2015.
Source: PubMed