Therapeutic monoclonal antibodies with a focus on hereditary angioedema

Monoclonal antibodies (mAbs) have been shown to be effective and generally safe across a continually expanding list of therapeutic areas. We describe the advantages and limitations of mAbs as a therapeutic option compared with small molecules. Specifically, we discuss a novel mAb in the treatment of he-reditary angioedema (HAE), a rare and potentially life-threatening condition characterized by recurrent unpredictable swelling attacks. HAE is mediated by dysregulation of plasma kallikrein activity leading to overproduction of bradykinin. Current prophylactic treatment for HAE includes androgens or replace-ment of the endogenous plasma kallikrein inhibitor, C1 inhibitor. However, there remains an unmet need for an effective, less burdensome treatment option. Lanadelumab is a fully human mAb targeting plasma kallikrein. Results from clinical trials, including a pivotal Phase 3 study and its ensuing open-label extension study, demonstrated that lanadelumab is associated with few treatment-related adverse events and reduced the rate of HAE attacks. This novel treatment option has the potential to significantly improve the lives of patients with HAE. (c) 2022 Japanese Society of Allergology. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

Monoclonal antibodies (mAbs) have shown efficacy and safety in various therapeutic areas. This article discusses the advantages and limitations of mAbs compared to small molecules and introduces a novel mAb for the treatment of hereditary angioedema (HAE), a rare and life-threatening condition characterized by recurrent swelling attacks. Lanadelumab, a fully human mAb targeting plasma kallikrein, has demonstrated promising results in clinical trials, including a pivotal Phase 3 study. It has the potential to provide an effective and less burdensome treatment option for HAE patients.