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Commentary
Nature Immunology  5, 695 - 698 (2004)
doi:10.1038/ni0704-695

Drug development strategies for asthma: in search of a new paradigm

Patrick G Holt1, Peter D Sly1, Fernando D Martinez2, Scott T Weiss3, Bengt Björkstén4, Erika von Mutius5 & Ulrich Wahn6

1  Patrick G. Holt and Peter D. Sly are with the Telethon Institute for Child Health Research, and Centre for Child Health Research, The University of Western Australia, Perth, Western Australia. patrick@ichr.uwa.edu.au

2  Fernando D. Martinez is at the Arizona Respiratory Center, University of Arizona, Tucson, Arizona, USA.

3  Scott T. Weiss is in the Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

4  Bengt Björkstén is in the Centre for Allergy Research and Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

5  Erika von Mutius is at the Dr. von Hauner Children's Hospital, University of Munich, Munich, Germany.

6  Ulrich Wahn is at the University Hospital Charite-Virchow, Berlin, Germany.

The spiraling costs of asthma treatment seem set to continue rising, given the equivocal performance of the latest generation of specific anti-inflammatory drugs in trials in adult asthmatics. We argue that the continuation of this trend is inevitable unless there is a substantial realignment of entrenched drug development policy in the pharmaceutical industry and a parallel shift in licensing policy by regulatory authorities to encourage the development of drugs capable of halting the progression from acute to chronic asthma when the disease first manifests in childhood. The theoretical framework for such an approach, including proof-of-principle data from studies in children with early-stage disease and a range of candidate drugs, already exists. What is needed is informed debate on the risks versus potential benefits of this approach.

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Nature Immunology
ISSN: 1529-2908
EISSN: 1529-2916
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