title: The safety of monoclonal antibodies in asthma.
abstract: BACKGROUND
  In the last two decades the knowledge of the mechanisms of the inflammatory processes underlying asthma rapidly evolved, several key mediators (cytokines and receptors) were identified, and the laboratory techniques have allowed us to synthesize monoclonal antibodies highly specific for those target molecules. Nowadays, many biological agents are investigated in asthma (with anti IgE being the only commercially available). The clinical efficacy of some biologics was demonstrated in many cases, however, the safety issue has progressively emerged and has been recognized as a crucial aspect.
  
  
  METHODS
  We summarized the currently available knowledge on the safety and side effects of biologics in asthma, as derived by reviews, meta analyses and clinical trials. PubMed was searched with the terms anti IL-x [AND] safety [OR] side effects, within the categories "clinical trial", meta-analysis" and "review". Case reports were excluded. The authors collegially selected the relevant entries to be included.
  
  
  CONCLUSIONS
  Overall, the safety of most of the investigated agents seems to be satisfactory, a certain risk of side effects remains present, and is variable for the different molecules. Thus caution must be paid in evaluating the risk to benefit ratio. Specific biomarkers to predict the response to each biological are urgently needed to improve the safety profile.
authors.affiliation: a Allergy and Respiratory Diseases , IRCCS San Martino, IST, University of Genoa , Genova , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.affiliation: b Immunoallergology Unit , AOU Careggi, University of Florence , Florence , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Matucci
authors.affiliation: b Immunoallergology Unit , AOU Careggi, University of Florence , Florence , Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vultaggio
authors.affiliation: a Allergy and Respiratory Diseases , IRCCS San Martino, IST, University of Genoa , Genova , Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Bagnasco
authors.affiliation: a Allergy and Respiratory Diseases , IRCCS San Martino, IST, University of Genoa , Genova , Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Mincarini
authors.affiliation: c Centre of Excellence DENOTHE, Department of Experimental and Clinical Medicine , University of Florence , Florence , Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Maggi
authors.affiliation: a Allergy and Respiratory Diseases , IRCCS San Martino, IST, University of Genoa , Genova , Italy.
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D001685:Biological Factors / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000473:pathology; D018836:Inflammation Mediators / Q000378:metabolism
chemical_list: D018927:Anti-Asthmatic Agents; D000911:Antibodies, Monoclonal; D001685:Biological Factors; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators
keywords: Asthma; adverse events; allergic asthma; cytokine; monoclonal antibody; safety; severe asthma