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

Rohit K. Katial, Greg W. Bensch, William W. Busse, Bradley E. Chipps, Joshua L. Denson, Anthony N. Gerber, Michael E. Wechsler, Joshua L. Denson, Anthony N. Gerber, Joshua S. Jacobs, Monica Kraft, Richard J. Martin, Parameswaran Nair

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)S1-S14
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume5
Issue number2
DOIs
StatePublished - Mar 1 2017

Keywords

  • Biologic therapy
  • Eosinophil
  • FeNO
  • Monoclonal antibody
  • Periostin
  • Refractory asthma
  • Severe asthma

ASJC Scopus subject areas

  • Immunology and Allergy

Fingerprint Dive into the research topics of 'Changing Paradigms in the Treatment of Severe Asthma: The Role of Biologic Therapies'. Together they form a unique fingerprint.

Cite this