Several antibodies have been repurposed for use in retinal diseases such as age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy. Anti-VEGF (Bevacizumab/Avastin®, Ranibizumab/Lucentis®) and anti-TNF-ꭤ (Infliximab/Remicade®, Adalimumab/Humira®) therapies have been quite successful in treating neovascularization and inflammation in the eye. Many other fully-human and Fc engineered antibodies against amyloid beta peptides and cytokines are currently under development for better efficacy.
Asthma is a chronic inflammation of the lower respiratory tract caused by multiple underlying pathological factors. Exacerbations can be triggered by allergens causing severe episodes. Omalizumab/Xolair® is the first mAb drug approved for severe asthma, which targets IgE and inhibits the allergic cascade. MAbs against other targets in the eosinophil maintenance pathway, such as IL-5 (Mepolizumab/Nucala®, Benralizumab/Fasenra®, and Reslizumab/Cinqaero®) and IL-4Rα (Dupilumab/Dupixent®) have also been approved, with numerous others under clinical trials.
XLH is an X-linked dominant form of rickets with a defective PHEX gene. This results in overactivity of fibroblast growth factor 23 (FGF23), leading to hypophosphatemia. Burosumab (Crysvita®) targeting FGF23 is the first-in-class drug approved for the treatment of this disease.
Migraine is characterized by severe throbbing pain which could be episodic or chronic. Calcitonin gene-related peptide (CGRP) is a vasodilator that is known to play a role in the pain process in migraines. The anti-CGRP antagonistic mAbs, Erenumab (Aimovig®), Fremanezumab (Ajovy®), and Galcanezumab (Emgality®) have been recently approved for the prevention of migraine attacks.
The extracellular accumulation of amyloid betapeptides (Aβ) has been found to be a causative factor of dementia in many neurodegenerative diseases like Alzheimer’s. Many anti-Aβ mAbs such as Solanezumab and Bapineuzumab are currently under phase II/III clinical trials.
Immunopharmacotherapy is the latest therapeutic strategy that focuses on blocking the drugs before they reach the central nervous system, rather than treating the drug effects on the brain. A fully human anti-cocaine antibody, GNCgzk, has shown promising results in clinical trials for the treatment of cocaine dependency and cocaine-induced acute toxicities. MAbs against other substances including nicotine, PCP, and methamphetamine have also demonstrated potential efficacy in animal models.