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

Research output: Contribution to journalArticle

30 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1393-1402
Number of pages10
JournalEuropean Respiratory Journal
Volume45
Issue number5
DOIs
StatePublished - May 1 2015

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Wilkes, D. S., Chew, T., Flaherty, K. R., Frye, S., Gibson, K. F., Kaminski, N., Klemsz, M. J., Lange, W., Noth, I., & Rothhaar, K. (2015). Oral immunotherapy with type v collagen in idiopathic pulmonary fibrosis. European Respiratory Journal, 45(5), 1393-1402. https://doi.org/10.1183/09031936.00105314