title: Evaluation of New Drugs for Asthma and COPD: Endpoints, Biomarkers and Clinical Trial Design.
abstract: There remains a considerable need to develop novel therapies for patients with asthma and chronic obstructive pulmonary disease (COPD). The greatest challenge at the moment is measuring the effects of novel anti-inflammatory drugs, as these drugs often cause only small effects on lung function. Measurements that demonstrate the pharmacological and clinical effects of these drugs are needed. Furthermore, we now recognise that only subgroups of patients are likely to respond to these novel drugs, so using biomarkers to determine the clinical phenotype most suitable for such therapies is important. An endotype is a subtype of a (clinical) condition defined by a distinct pathophysiological mechanism. An endotype-driven approach may be more helpful in drug development, enabling drugs to be targeted specifically towards specific biological mechanisms rather than clinical characteristics. This requires the development of biomarkers to define endotypes and/or to measure drug effects. This newer approach should continue alongside efforts to optimise the measurement of clinical endpoints, including patient-reported outcome measurements, required by drug regulatory authorities.
authors.affiliation: Medicines Evaluation Unit, University of Manchester, University Hospital of South Manchester Foundations Trust, Langley Building, Southmoor Road, Wythenshawe, Manchester, M23 9Q2, UK. dsingh@meu.org.uk.
authors.forename: Dave
authors.initials: D
authors.lastname: Singh
mesh_terms: D000818:Animals; D001249:Asthma / Q000188:drug therapy*; D015415:Biomarkers / Q000032:analysis*; D016535:Bronchial Hyperreactivity / Q000188:drug therapy; D002986:Clinical Trials as Topic; D023381:Endpoint Determination; D006801:Humans; D000071066:Patient Reported Outcome Measures; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012107:Research Design
chemical_list: D015415:Biomarkers
keywords: Asthma; Biomarkers; COPD; Induced sputum; Minimal clinical important differences; Patient reported outcomes