Lebrikizumab reduces serum periostin in asthma patients with elevated baseline periostin

Background: Periostin is a matricellular protein induced in airway epithelia by interleukin-13 (IL13) and a good systemic biomarker for IL13 activity. Lebrikizumab, a humanized monoclonal antibody, binds IL13 and improved lung function in moderate-to-severe asthma patients (pts) with elevated baseline serum periostin in a Phase II study. Aims: To examine the effect of blocking IL13 on systemic periostin levels in pts with uncontrolled asthma, despite inhaled corticosteriods. Methods: Pts (n=218) were randomized to lebrikizumab 250 mg (n=106) or placebo (PB) (n=112) SC every 4 weeks for 6 doses, with 12 weeks follow-up (NCT00930163). Serum periostin was measured at baseline and throughout the study. Pts were classified as periostin-high (≥median) or periostin-low ( Results: PB-corrected reductions in periostin were evident after 1 week of lebrikizumab treatment: 5.4% baseline reduction across all pts and 7.3% baseline reduction in periostin-high pts (p 90%) who were periostin-low at baseline maintained the periostin levels Conclusions: Lebrikizumab reduced serum periostin in periostin-high, but not periostin-low pts, vs placebo. These data suggest that in asthma pts, elevated serum periostin levels are dependent on IL13 activity.