Pulmonary Eosinophilia

近日，三生国健发布最新年报，2023年，其总营收10.14亿元，同比增长22.84%；净利润2.95亿元，暴涨497.63%。在经历了三年的战略调整后，三生国健的发展终于又回到了正轨，不论是总营收还是净利润都回到了调整前的高度。此次王者归来，三生国健进行了战略收缩，将主要精力全部放在了自免管线上。轻装简行下，三生国健显得更加稳健，布局也更加合理，兼顾了短中长期的发展平衡，一切都在向好的方向前进。机遇与挑战并存对营收和利润大幅增长的原因，三生国健在年报中进行了剖析。营业收入增长的原因主要是核心产品益赛普加快了市场渗透，带来了销量的增长；在医生和患者认同度的提升以及药品可及性改善等多重因素促进下，赛普汀持续快速放量增长；取得与沈阳三生制药合作的抗体肿瘤及眼科管线授权收入部分款项。利润的大幅增长则是持续的工艺优化、内部精细化管理以及对部分研发费用进行资本化处理等几大方面的原因共同促进。2023年，三生国健研发投入资本化3188.58万元，虽然同比增长了95.05%，但相对于总利润来说占比很小，因此净利润增长的主要原因还是来源于药品的销售增长。分行业情况看，2023年全年，三生国健的医药制造收入8.42亿元，增长17.27%；CDMO业务增长6397.91万元，下降32.97%；授权许可收入9928.68万元。三生国健2023年营收组成来源：年报营收的主力依然是三款已上市的药品：益赛普（TNF-α抑制剂）、健尼哌（CD25单抗）、赛普汀（HER-2单抗）。益赛普是是中国风湿病领域第一个上市的肿瘤坏死因子（TNF-α）抑制剂，也是中国首个上市的全人源抗体类药物。就是因为益赛普的存在，“药王”修美乐（阿达木单抗）在中国才会被长期压制，遗憾折戟。益赛普在2023年度实现国内销售收入5.7亿元，增长10.50%。但是益赛普在过去两年也遇到了集采的挑战，在广东牵头的区域联盟集采中，益赛普降价约60%中标。不过益赛普预充针剂型于2023年3月获批上市，成为国产重组人II型肿瘤坏死因子受体-抗体融合蛋白产品中的首个预充式剂型，为三生国健这一支柱产品拉回了部分业绩。赛普汀（伊尼妥单抗）虽然被赋予一个新名称，但实际上仍旧是曲妥珠单抗生物类似药。作为国产首款曲妥珠单抗生物类似药，赛普汀优势不是特别明显。不过随着赛普汀被列入《中国临床肿瘤学会（CSCO）乳腺癌诊疗指南》作为晚期乳腺癌患者全程抗HER2治疗的基础药物之后，医生和患者认可度不断提高，2023年销售收入实现41.8%增长。健尼哌（重组抗CD25人源化单克隆抗体注射液）是目前国内唯一获批上市的人源化抗CD25单抗，在国内已上市产品中主要的竞争产品为诺华的舒莱。就产品特性而言，健尼哌作为人源化抗CD25单抗，免疫原性更低且安全性更高，2023年度健尼哌实现了59.38%收入增长。这三款目前已商业化的产品，在前景上都有各自的短板。在国内，TNF-α抑制剂和曲妥珠单抗生物类似药已经越来越多，市场越来越拥挤，而且均已达到集采的条件，虽然目前生物药的国家集采还未最终定型，但始终是垂悬在三生国健头上的达克摩斯之剑；而健尼哌的市场规模不大，注定无法成为支柱。在激烈的竞争和极大的焦虑之下，三生国健毅然决然地剥离了抗肿瘤管线，一心专攻自免这个即将爆发的赛道。国内自免第一梯队2023年4月，三生国健发布公告宣布，为了进一步聚焦核心优势资产，优化产品管线，提升资金使用效率，降低临床开发风险，将其抗肿瘤项目602、609、705、眼科601A项目及丹生医药707项目独家授予给沈阳三生制药；将重组人鼠嵌合抗CD20单克隆抗体注射液（304R）项目所产生的所有化合物及其成为药物后的其他在全球范围内的一切权利转让给沈阳三生制药，技术转让费为9930万元。剥离抗肿瘤管线之后，三生国健的研发管线中共开展14个自免项目（较去年同期增加8个临床新项目），其中包括4个临床III期项目，6个临床II期项目，2个临床I期项目，2个临床项目处于IND获批阶段。三生国健研发管线来源：2023年年报608（IL-17A单抗）608是三生国健自主研发的IL-17A靶点药物，针对斑块状银屑病。在中重度银屑病患者中开展的III期临床研究结果提示已经达到主要终点和关键的次要终点，其他各项次要疗效终点均显著优效于安慰剂组。目前针对中重度银屑病患者的适应症已提交上市申请；强直性脊柱炎II期临床已入组。根据药渡数据不完全统计，国内临床阶段的IL-17靶向药物共有18款，三生国健的608与智翔金泰的赛立奇单抗、UCB的比吉利珠单抗、恒瑞医药的夫那奇珠单抗同处第一梯队。国内临床阶段的IL-17靶向药物来源：华创证券研报611（IL-4Rα单抗）611是三生国健自主研发设计、筛选并人源化的IL-4Rα单抗，具有全新的氨基酸序列。对中重度特应性皮炎的患者II期临床研究数据分析结果显示：接受611 600mg+300mg Q2W和600mg+300mgQ4W给药后，EASI较基线改善75%和IGA 0/1且下降≥2分的疗效应答确切，起效迅速，疗效持续；611两个给药剂量组，在EASI-75和IGA0/1下降≥2分应答上均明显优于安慰剂，且有统计学意义。目前611已完成在中重度特应性皮炎患者的临床III期研究的所有受试者入组；完成COPD适应症II期的部分受试者入组。赛诺菲/再生元公司的度普利尤单抗是全球首款也是唯一上市的IL-4Rα单抗，2023年销售额达到107.15亿欧元（115.7亿美元），已经具备挑战自免“药王”的实力。根据药渡数据不完全统计，国内临床阶段的IL-4Rα单抗共有11款，康诺亚的IL-4R单抗Stapokebart（CM310）目前已有多项适应症处于临床III期，包括特应性皮炎、过敏性鼻炎、哮喘、慢性鼻窦炎伴鼻息肉；康乃德的Rademikibart（CBP-201）、三生国健的SSGJ-611、智翔金泰的GR1802、康方生物的曼多奇单抗、麦济生物的Comekibart、荃信生物的QX005N、恒瑞医药的SHR-1819、正大天晴的TQH2722等IL-4R单抗也先后进入临床II期。国内临床阶段的IL-4Rα单抗研发管线来源：华创证券研报610（IL-5单抗）610是抗IL-5人源化单抗，针对18岁及以上重度嗜酸性粒细胞性哮喘维持治疗的附加治疗，具有全新的抗体可变区序列，目前尚无相同靶点抗体药物在国内上市。在已完成的重度嗜酸性粒细胞哮喘患者中II期临床研究结果提示：610两个剂量组给药（100mg Q4W及300mg Q4W）在肺功能改善方面，均显示明显的优于安慰剂组。目前610已启动在重度嗜酸性粒细胞性哮喘的III期临床研究入组。根据药渡数据不完全统计，国内临床阶段的靶向IL-5药物共有6款，三生国健的610有望在国产第一梯队上市。国内临床阶段的IL-5靶向药物来源：华创证券研报613（IL-1β抗体）613是一个全新的抗IL-1β抗体，目前国内尚无自主针对IL-1β的单抗上市。在已完成的在中国急性痛风患者的II期临床研究结果显示：SSGJ-613在急性痛风性关节炎疼痛缓解和预防复发方面疗效确切，表现出良好的安全性和耐受性。目前613已完成在痛风性关节炎间歇期的II期临床研究入组；已完成在急性痛风性关节炎患者的临床III期所有受试者入组。根据药渡数据不完全统计，国内临床阶段的IL-1β单抗仅有3款，诺华的卡那奴单抗，金赛药业的金纳单抗与613均已处于临床III期。2023年，三生国健共取得7个临床批件，包括608的治疗放射学阴性中轴型脊柱炎和强制性脊柱炎、611的儿童和青少年特应性皮炎、慢性鼻窦炎伴鼻息肉、COPD、621的中国和美国COPD的临床批件。在自免药物国产化替代的浪潮下，加之此前与国际市场存在较大的市场落差的局面下，自免赛道正值爆发的前夕。自免市场有多大，在中国的前景如何，可详见不久前药渡关于荃信生物的分析《今日，荃信生物正式在港交所上市》（加链接,斜体,标蓝色）。结语从三生国健的在研管线中我们看到，布局的靶点与智翔金泰、荃信生物等专注自免的Biotech高度相似。这也就意味着，时间成为竞争的关键。但与这些新兴Biotech不同的是，三生国健已通过一些成熟产品实现正向循环。虽然躺在蜜罐里太久，初遇挑战时有些茫然无措，但三年调整期已过，我们看到了一个更加紧实的三生国健。在即将爆发的自免赛道上，三生国健必将占有较为重要的一席之地。后续发展如何，药渡还将持续关注。参考资料三生国健年报、官网、公告等国泰君安、华创证券研报《三生国健：年内涨幅67%、全力押注自免赛道能否焕发第二春？》，药渡Daily，2023-10-172024FDA新药风云榜，获批拒绝结果汇总非阿片化长效改良来袭，镇痛新时代！MNC巨资追逐核药创新，国内企业加速抢滩点击“蓝字”    关注我们吧！

2024年3月1日，美国罗克维尔和中国苏州——信达生物制药集团（香港联交所股票代码：01801），一家致力于研发、生产和销售肿瘤、自身免疫、代谢及心血管、眼科等重大疾病领域创新药物的生物制药公司，宣布IBI3002的首次人体（FIH）临床I期研究已在澳大利亚完成首例受试者给药。IBI3002是一种全球首创（first-in-class）的靶向白细胞介素4受体α（IL-4Rα）和胸腺基质淋巴细胞生成素（TSLP）的双特异性抗体。本项FIH研究（NCT06213844）是一项随机、双盲、安慰剂对照、单次给药剂量递增（SAD）研究，旨在评估IBI3002在健康受试者和轻中度哮喘受试者中的安全性、耐受性、药代动力学（PK）和药效学（PD，仅在哮喘受试者中），以支持IBI3002后续全球临床开发。IBI3002是信达生物自主研发的人源化双特异性抗体，靶向细胞表面IL-4Rα和警报素细胞因子TSLP，用于治疗包括哮喘在内的炎症性疾病。IL-4受体介导了IL-4信号通路（1型和2型）和IL-13信号通路（2型），两种细胞因子信号通路在2型炎症性疾病的病理生理学中均起关键作用1。TSLP是一种上皮细胞来源的警报素细胞因子，可触发哮喘中的2型和非2型炎症2。IBI3002具有高效的IL-4Rα和TSLP共同阻断功能。体外功能学实验显示比同靶点的已上市单克隆抗体更优。通过同时靶向IL-4Rα和TSLP，IBI3002具有抑制2型和非2型炎症的潜力，在抑制2型炎症方面具有潜在的协同作用，有望在治疗2型炎症性疾病中展现优效性。信达生物制药集团临床开发副总裁钱镭博士表示：“在过去的几十年里，医疗界对哮喘的病理生理机制/表型和治疗选择的认知有了显著增加，特别是通过引入生物制剂治疗重度哮喘这一精准治疗的策略，为哮喘管理带来革命性的变革。高选择性药物通过靶向免疫炎症级联的特定步骤，有潜力进一步突破广大严重哮喘患者的治疗局限，并有望在多种重度哮喘炎症表型中实现最佳疾病控制；同时，我们也期待推进该分子未来在哮喘和其他多种炎症性疾病中的进一步开发。”关于哮喘- 滑动查看更多介绍 -哮喘是一种由多种免疫细胞、细胞因子及炎症介质介导，累及全年龄段人群的异质性疾病，以喘息、气促、咳嗽和胸闷等多种症状为特征，与慢性气道炎症、可变的气流受限和气道高反应性相关3。根据2015年全球疾病负担（GBD）研究，约有3.58亿人患有哮喘4。根据气道或外周血细胞特征，哮喘可大致分为嗜酸性粒细胞性和非嗜酸性粒细胞性哮喘。嗜酸性粒细胞炎症主要由2型炎症驱动，包括2型辅助T细胞和2型固有淋巴细胞5。与嗜酸性粒细胞性哮喘相比，对于非嗜酸性粒细胞性哮喘的了解仍不充分6。高达10%的成人哮喘患者和2.5%的儿童哮喘患者患有重度哮喘7。尽管接受了足够的大剂量吸入治疗，重度哮喘患者仍存在症状持续或频繁急性加重，需要反复系统性糖皮质激素短期或维持治疗8。在这些患者中，需要给予额外治疗（可能包括生物制剂）以减轻疾病负担2,3。关于IBI3002- 滑动查看更多介绍 -IBI3002是一款全球首创靶向细胞表面IL-4Rα和警报素细胞因子TSLP的双特异性抗体。该分子具有高效的IL-4Rα和TSLP共同阻断功能。体外功能学实验显示比同靶点的已上市单克隆抗体更优。通过同时靶向IL-4Rα和TSLP，IBI3002具有治疗包括哮喘在内多种炎症性疾病的潜力。IL-4是2型淋巴细胞分化的中心介质；它诱导产生2型相关细胞因子，如IL-5、IL-9、IL-13和/或2型相关趋化因子，如胸腺和活化调节趋化因子(TARC/CCL17)和嗜酸性粒细胞趋化因子-3。IL-4参与调节B细胞的同种型类别转换以产生血清IgE，并通过释放IL-5招募嗜酸性粒细胞。尽管IL-13在这些促炎过程中显示出一些冗余性，但它在介导杯状细胞增生、粘液产生、平滑肌收缩性和气道高反应性方面具有额外的作用。总的来说，IL-4和IL-13共同在2型炎症中起关键作用1。TSLP是一种上皮细胞来源的警报素细胞因子，它在2型炎症诱导和通过IL-4、IL-5和IL-13产生的Th2细胞分化与成熟中占据上游位置。TSLP也被认为是哮喘中非2型炎症的触发因素2。关于信达生物- 滑动查看更多介绍 -“始于信，达于行”，开发出老百姓用得起的高质量生物药，是信达生物的使命和目标。信达生物成立于2011年，致力于开发、生产和销售肿瘤、代谢及心血管、自身免疫、眼科等重大疾病领域的创新药物。公司已有10款产品获得批准上市，同时还有3个品种在NMPA审评中，4个新药分子进入III期或关键性临床研究，另外还有19个新药品种已进入临床研究。公司与海内外药企深入合作加速药物创新，与礼来、罗氏、赛诺菲、Adimab、Incyte和MD Anderson 癌症中心等国际合作方达成30多项战略合作。信达生物在不断开发创新药物、谋求自身发展的同时，始终心怀科学善念，坚守“以患者为中心”，心系患者并关注患者家庭，积极履行社会责任。信达生物希望和大家一起努力，提高中国生物制药产业的发展水平，以满足百姓用药可及性和人民对生命健康美好愿望的追求。详情请访问公司网站：www.innoventbio.com或公司领英账号：Innovent Biologics。  声明：信达不推荐任何未获批的药品/适应症使用。参考文献：1.Zhu J. T helper 2 (Th2) cell differentiation, type 2 innate lymphoid cell (ILC2) development and regulation of interleukin-4 (IL-4) and IL-13 production[J]. Cytokine, 2015, 75(1): 14-24.2. Brusselle G G, Koppelman G H. Biologic therapies for severe asthma[J]. New England Journal of Medicine, 2022, 386(2): 157-171.3. Global Initiative for Asthma. 2023 GINA Report, Global Strategy for Asthma Management and Prevention. 2023.4. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 [published correction appears in Lancet Respir Med. 2017 Oct;5(10 ):e30]. Lancet Respir Med. 2017;5(9):691-706.5. Gans MD, Gavrilova T. Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes. Paediatr Respir Rev. 2020;36:118-127.6. Israel E, Reddel H K. Severe and difficult-to-treat asthma in adults[J]. New England Journal of Medicine, 2017, 377(10): 965-976.7. Settipane RA, Kreindler JL, Chung Y, Tkacz J. Evaluating direct costs and productivity losses of patients with asthma receiving GINA 4/5 therapy in the United States. Ann Allergy Asthma Immunol 2019; 123(6): 564-572.e3.8.Caminati M, Vaia R, Furci F, Guarnieri G, Senna G. Uncontrolled Asthma: Unmet Needs in the Management of Patients. J Asthma Allergy. 2021;14:457-466.前瞻性声明本新闻稿所发布的信息中可能会包含某些前瞻性表述。这些表述本质上具有相当风险和不确定性。在使用“预期”、“相信”、“预测”、“期望”、“打算”及其他类似词语进行表述时，凡与本公司有关的，目的均是要指明其属前瞻性表述。本公司并无义务不断地更新这些预测性陈述。这些前瞻性表述乃基于本公司管理层在做出表述时对未来事务的现有看法、假设、期望、估计、预测和理解。这些表述并非对未来发展的保证，会受到风险、不确性及其他因素的影响，有些乃超出本公司的控制范围，难以预计。因此，受我们的业务、竞争环境、政治、经济、法律和社会情况的未来变化及发展的影响，实际结果可能会与前瞻性表述所含资料有较大差别。

ROCKVILLE, Md. and SUZHOU, China, Feb. 29, 2024 /PRNewswire/ -- Innovent Biologics, Inc. (Innovent) (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncology, metabolic, autoimmune, ophthalmology and other major diseases, announces that the first participant has been dosed in Australia in a first-in-human (FIH) phase 1 clinical trial of IBI3002, a global first-in-class bispecific antibody targeting Interleukin 4 receptor α (IL-4Rα) and thymic stromal lymphopoietin (TSLP). This FIH study (NCT06213844) is a randomized, double-blind, placebo-controlled, single ascending dose (SAD) study to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) (only in participants with asthma) of IBI3002 in healthy participants and participants with mild to moderate asthma, and to support further global clinical development of IBI3002. IBI3002 is a humanized bispecific antibody targeting cell surface IL-4Rα and the alarmin cytokine TSLP, discovered and developed by Innovent for the treatment of inflammatory diseases, including asthma. IL-4 receptors mediate the IL-4 signaling (both type 1 and type 2) and the IL-13 signaling (type 2). Both cytokine signaling pathways play key roles in the pathophysiology of type 2 (T2) inflammatory disorders1. TSLP is an epithelial cell-derived alarmin cytokine and triggers both T2 and non-T2 inflammation in asthma2. IBI3002 has high-efficient dual-blocking function on both IL-4Rα and TSLP. In-vitro assays have shown superiority over the marketed monoclonal antibodies to respective target. By targeting both IL-4Rα and TSLP, IBI3002 is hypothesized to have potential effect in suppressing T2 and non-T2 inflammation. The potential synergistic effect in suppressing T2 inflammation is believed to be the basis of its superior efficacy in the treatment of T2 inflammatory disorders. Dr. Lei Qian, Vice President of Clinical Development at Innovent, stated, "In the last few decades, knowledge about both pathophysiological mechanisms, clinical phenotypes and therapeutic options for asthma have significantly increased. In particular, the introduction of biologics for severe asthma paved the way to a true revolution in the field of asthma management, by potentially allowing a precision medicine approach. Targeting specific steps of the immune-inflammatory cascade through highly selective drugs represents a true revolution in the field of severe asthma management, and brings with it the potential of achieving optimal disease control in different severe asthma inflammatory phenotypes. We are looking forward to the development of this molecule in asthma and other inflammatory diseases." About Asthma Asthma is a heterogeneous disease driven by multiple immune cells, cytokines and inflammatory mediators, affecting all age groups. Characterized by variable symptoms of wheeze, shortness of breath, cough, and chest tightness, asthma is associated with chronic airway inflammation, reversible airflow limitation, and airway hyperresponsiveness3. According to the 2015 Global Burden of Disease (GBD) study, about 358 million people are suffering from asthma4. Asthma can be broadly classified as eosinophilic or non-eosinophilic on the basis of airway or peripheral blood cellular profiles. Eosinophilic inflammation is driven predominantly by T2 inflammation, including T-helper cells type 2 and group 2 innate lymphoid cells5. Compared with eosinophilic asthma, non-eosinophilic asthma is poorly understood6. Up to 10% of adults and 2.5% of children with asthma have severe asthma7. Patients with severe asthma have persistent symptoms or frequent exacerbations that require repetitive systemic glucocorticoid bursts or maintenance, despite adequate treatment with high-dose inhaled treatments8. In these patients, add-on treatment, which may include biologic therapies, is needed to reduce the disease burden2,3. About IBI3002 IBI3002 is a global first-in-class bispecific antibody targeting cell surface IL-4Rα and the alarmin cytokine TSLP. It has high-efficient dual-blocking function on both IL-4Rα and TSLP. In-vitro assays have shown superiority over the marketed monoclonal antibodies to respective targets. By simultaneously targeting IL-4Rα and TSLP, IBI3002 has the potential of treating several inflammatory disorders, including asthma. IL-4 is a central mediator of type 2 lymphocyte cell differentiation; it induces the production of type 2 associated cytokines such as IL-5, IL-9, IL-13, and/or type 2 related chemokines as thymus and activation-regulated chemokine (TARC/CCL17) and eotaxins-3. IL-4 involved in B cells regulated isotype class switching to produce serum IgE, and the eosinophils recruitment through IL-5 releasement. Although IL-13 displays some redundancies in these pro-inflammatory processes, it has additional roles in mediating goblet cell hyperplasia, mucus production, smooth muscle contractility, and airway hyperresponsiveness. Together, IL-4 and IL-13 play critical roles in T2 inflammation1. TSLP is an epithelial cell-derived alarmin cytokine that occupies an upstream position in the T2 inflammation induction and Th2 cells differentiation and maturation via IL-4, IL-5 and IL-13 production. TSLP is also believed to be a trigger of non-T2 inflammation in asthma 2. About Innovent Innovent is a leading biopharmaceutical company founded in 2011 with the mission to provide high-quality biologics that are affordable to all. The company discovers, develops, manufactures and commercializes innovative medicines that treat some of the most intractable illnesses. Its pioneering therapies to treat cancer, cardiovascular and metabolic, autoimmune and eye diseases. Innovent has 10 products in the market, 3 new drug applications under the NMPA review, 4 assets in Phase III or pivotal clinical trials and 20 more molecules in early clinical stage. Innovent partners with over 30 global healthcare leaders, including Eli Lilly, Roche, Sanofi, Adimab, Incyte and MD Anderson Cancer Center. Guided by the motto, "Start with Integrity, Succeed through Action," Innovent maintains the highest standard of industry practices and works collaboratively to advance the biopharmaceutical industry so that first-rate pharmaceutical drugs can become widely accessible. For more information, visit , or follow Innovent on Facebook and LinkedIn. Statement: Innovent does not recommend the use of any unapproved drug (s)/indication (s). Forward-looking statement This news release may contain certain forward-looking statements that are, by their nature, subject to significant risks and uncertainties. The words "anticipate", "believe", "estimate", "expect", "intend" and similar expressions, as they relate to Innovent Biologics ("Innovent"), are intended to identify certain of such forward-looking statements. The Company does not intend to update these forward-looking statements regularly. These forward-looking statements are based on the existing beliefs, assumptions, expectations, estimates, projections and understandings of the management of the Company with respect to future events at the time these statements are made. These statements are not a guarantee of future developments and are subject to risks, uncertainties and other factors, some of which are beyond the Company's control and are difficult to predict. Consequently, actual results may differ materially from information contained in the forward-looking statements as a result of future changes or developments in our business, the Company's competitive environment and political, economic, legal and social conditions. The Company, the Directors and the employees of the Company assume (a) no obligation to correct or update the forward-looking statements contained in this site; and (b) no liability in the event that any of the forward-looking statements does not materialise or turn out to be incorrect. References: 1. Zhu J. T helper 2 (Th2) cell differentiation, type 2 innate lymphoid cell (ILC2) development and regulation of interleukin-4 (IL-4) and IL-13 production[J]. Cytokine, 2015, 75(1): 14-24. 2. Brusselle G G, Koppelman G H. Biologic therapies for severe asthma[J]. New England Journal of Medicine, 2022, 386(2): 157-171. 3. Global Initiative for Asthma. 2023 GINA Report, Global Strategy for Asthma Management and Prevention. 2023. 4. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015 [published correction appears in Lancet Respir Med. 2017 Oct;5(10 ):e30]. Lancet Respir Med. 2017;5(9):691-706. 5. Gans MD, Gavrilova T. Understanding the immunology of asthma: Pathophysiology, biomarkers, and treatments for asthma endotypes. Paediatr Respir Rev. 2020;36:118-127. 6. Israel E, Reddel H K. Severe and difficult-to-treat asthma in adults[J]. New England Journal of Medicine, 2017, 377(10): 965-976. 7. Settipane RA, Kreindler JL, Chung Y, Tkacz J. Evaluating direct costs and productivity losses of patients with asthma receiving GINA 4/5 therapy in the United States. Ann Allergy Asthma Immunol 2019; 123(6): 564-572.e3. 8. Caminati M, Vaia R, Furci F, Guarnieri G, Senna G. Uncontrolled Asthma: Unmet Needs in the Management of Patients. J Asthma Allergy. 2021;14:457-466. SOURCE Innovent Biologics