Lirentelimab provides favorable outcomes in severe allergic conjunctivitis: Study

USA: Lirentelimab was very well tolerated and can relieve severe allergic conjunctivitis (AC), atopic symptoms, and decrease inflammatory mediators in patient's tears, says an article published in The Journal of Allergy and Clinical Immunology.

Allergic conjunctivitis is a chronic inflammatory ocular condition caused by eosinophils and mast cells that is commonly characterized by severe itching, watering or mucous discharge, discomfort, burning in both eyes, and redness and swelling of the conjunctiva. Atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC), and perennial allergic conjunctivitis are all severe variants of AC (PAC). AC disease processes entail an inflammatory response, with eosinophils and mast cells serving as major effector cells. Stephen D. Anesi and colleagues present the findings of a phase 1b, open-label research in patients with severe and chronic AC to explore the safety, tolerability, preliminary effectiveness, and pharmacodynamics (PD) of up to 6 monthly doses of lirentelimab.

Patients with chronic, extremely symptomatic atopic keratoconjunctivitis, vernal keratoconjunctivitis, and perennial AC who had a history of topical or systemic corticosteroid therapy were enrolled to receive up to 6 monthly lirentelimab infusions (dosage 1: 0.3 mg/kg, dose 2: 1 mg/kg, following doses: 1 or 3 mg/kg). Changes in peripheral blood eosinophils from baseline, changes in patient-reported symptoms, changes in investigator-reported changes in quality of life, ocular signs and symptoms, and changes in tear cytokine and chemokine levels were also evaluated in people suffering from severe and chronic AC.

The key findings of this study were as follow:

1. Thirty patients were recruited, with 87% having atopic comorbidities.

2. The mean improvement in the Allergic Conjunctivitis Symptom Questionnaire score and Ocular Symptom Scores after lirentelimab therapy was consistent among atopic keratoconjunctivitis, vernal keratoconjunctivitis, and perennial AC groups.

3. There was a significant improvement in atopic comorbidities, with symptoms of atopic dermatitis, asthma, and rhinitis reduced by 255%, 250%, and 263%, respectively.

4. After lirentelimab therapy, levels of major inflammatory mediators were lowered in the patient's tears. Mild to moderate infusion-related responses were the most prevalent side effects.

In conclusion, despite the lack of treatment choices and the disease's high incidence, there have been no therapeutic advances to alleviate the disease's burden. This is the first clinical trial of a biologic targeting allergic conjunctivitis, and it showed early effectiveness in lowering symptoms in individuals with moderate to severe AKC, VKC, and PAC.

Reference:

Anesi, S. D., Tauber, J., Nguyen, Q. D., Chang, P., Berdy, G. J., Lin, C. C., Chu, D. S., Levine, H. T., Fernandez, A. D., Roy, N., Asbell, P. A., Kantor, A. M., Chang, A. T., Singh, B., Rasmussen, H. S., & Foster, C. S. (2022). Lirentelimab for severe and chronic forms of allergic conjunctivitis. In Journal of Allergy and Clinical Immunology. Elsevier BV. https://doi.org/10.1016/j.jaci.2022.03.021