Changing Paradigms in the Treatment of Severe Asthma: The Role of Biologic Therapies.

Published

Journal Article (Review)

Cytokine antagonists are monoclonal antibodies that offer new treatment options for refractory asthma but will also increase complexity because they are effective only for patients with certain asthma subtypes that remain to be more clearly defined. The clinical and inflammatory heterogeneity within refractory asthma makes it difficult to manage the disease and to determine which, if any, biologic therapy is suitable for a specific patient. The purpose of this article is to provide a data-driven discussion to clarify the use of biologic therapies in patients with refractory asthma. We first discuss the epidemiology and pathophysiology of refractory asthma. We then interpret current evidence for biomarkers of eosinophilic or type 2-high asthma so that clinicians can determine potential treatments for patients based on knowledge of their effectiveness in specific asthma phenotypes. We then assess clinical data on the efficacy, safety, and mechanisms of action of approved and pipeline biologic therapies. We conclude by discussing the potential of phenotyping or endotyping refractory asthma and how biologic therapies can play a role in treating patients with refractory asthma.

Full Text

Cited Authors

  • Katial, RK; Bensch, GW; Busse, WW; Chipps, BE; Denson, JL; Gerber, AN; Jacobs, JS; Kraft, M; Martin, RJ; Nair, P; Wechsler, ME

Published Date

  • March 2017

Published In

Volume / Issue

  • 5 / 2S

Start / End Page

  • S1 - S14

PubMed ID

  • 28143691

Pubmed Central ID

  • 28143691

Electronic International Standard Serial Number (EISSN)

  • 2213-2201

International Standard Serial Number (ISSN)

  • 2213-2198

Digital Object Identifier (DOI)

  • 10.1016/j.jaip.2016.11.029

Language

  • eng