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Selecting the right biologic for your patients with severe asthma
Laurie A Manka1, Michael E Wechsler1
1Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, and The NJH Cohen Family Asthma Institute, Denver, Colorado.
Summary
Biologic medications targeting type 2 inflammation can improve outcomes for severe asthma patients. Clinicians should consider asthma endotype, biomarkers, and patient factors when selecting the best treatment.
Area of Science:
- Pulmonology and Immunology
- Pharmacology
Background:
- Severe asthma impacts 5-10% of adults, leading to higher morbidity and healthcare costs.
- Biologic therapies targeting the type 2 inflammatory pathway (IL-4, IL-5, IL-13) are emerging treatments.
- Type 2 inflammation is characterized by eosinophilia, elevated FeNO, and atopic features.
Purpose of the Study:
- To provide clinicians with key considerations for selecting appropriate biologic medications for severe asthma.
- To review the efficacy of biologic therapies in managing type 2-high severe asthma.
Main Methods:
- Comprehensive literature search of basic science and clinical trial data.
- Review of studies analyzing biologic medication outcomes in type 2-high severe asthma.
- Analysis of clinical biomarkers, exacerbation rates, lung function, and quality of life.
Main Results:
- Biologic medications significantly improve clinical biomarkers, reduce exacerbation rates, and enhance lung function and quality of life in type 2-high severe asthma.
- These therapies effectively target key mediators of type 2 airway inflammation.
Conclusions:
- Biologic therapies offer significant benefits for patients with severe asthma.
- Selection of biologic medication should be individualized based on asthma endotype, clinical biomarkers, and patient-centered factors.
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