Severe refractory asthma: current treatment options and ongoing research.

Area of Science:

• Pulmonology
• Immunology
• Pharmacology

Background:

• Severe refractory asthma significantly increases patient morbidity, healthcare costs, and reliance on oral corticosteroids (OCS).
• The emergence of biological therapies presents an opportunity to control severe asthma without OCS, but treatment selection is complex.
• Advancements in understanding disease mechanisms and biomarkers, particularly for the Th2-high endotype, facilitate personalized treatment strategies.

Purpose of the Study:

• To review available biological treatment options for severe refractory asthma.
• To discuss their mechanisms of action and clinical application.
• To clarify selection criteria for optimal patient outcomes.

Main Methods:

• Review of current literature on biological therapies for severe refractory asthma.
• Analysis of mechanisms of action and biomarker associations.
• Discussion of clinical practice considerations and treatment selection.

Main Results:

• Multiple biological agents targeting specific pathways are now available for severe asthma.
• Biomarker-guided selection, especially for Th2-high endotype, improves treatment efficacy.
• Understanding target overlap and phenotype specificity is crucial for clinical decision-making.

Conclusions:

• Biological therapies represent a significant advancement in managing severe refractory asthma.
• Personalized medicine approaches, guided by biomarkers, are essential for optimizing treatment selection.
• This review aims to guide clinicians in choosing the most appropriate biological therapy to improve patient outcomes and reduce OCS dependence.