Related Experiment Video
Updated: Jul 27, 2025
14:39
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
32.0K
Switching Biological Therapies in Severe Asthma
Giulia Scioscia1, Santi Nolasco2,3, Raffaele Campisi2
1Department of Medical and Surgical Sciences, University of Foggia, 71121 Foggia, Italy.
International Journal of Molecular Sciences
|June 10, 2023
Summary
Switching biologic therapies for severe asthma can be effective, especially for patients with high eosinophil counts. Treatment choice should consider patient history, biomarkers like blood eosinophils, and comorbidities such as nasal polyposis.
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Three classes of monoclonal antibodies (anti-IgE, anti-IL-5/IL-5Rα, anti-IL-4Rα) are approved for severe asthma in Italy.
- Randomized controlled trials and real-life studies assess efficacy and predictive factors for these biologics.
- Switching biologics is a strategy for patients with suboptimal response.
Purpose of the Study:
- To review current knowledge on switching biological therapies in severe asthma.
- To identify predictors of treatment response or failure after switching biologics.
- To summarize real-world evidence on biologic switching.
Main Methods:
- Review of real-life studies and randomized controlled trials on biologic switching in severe asthma.
- Analysis of patient characteristics associated with treatment response or failure.
- Synthesis of data regarding predictors of efficacy for different monoclonal antibodies.
Main Results:
- Most switching data originates from real-life studies.
- Omalizumab was frequently the initial biologic therapy.
- Patients switched due to suboptimal control often had higher baseline blood eosinophil counts and exacerbation rates, and were dependent on oral corticosteroids (OCS).
Conclusions:
- Switching biologics is a viable option for severe asthma patients with inadequate response.
- Patient's clinical history, biomarkers (blood eosinophils, FeNO), and comorbidities (nasal polyposis) can guide treatment selection.
- Further research is needed to characterize patient profiles benefiting from switching to different monoclonal antibodies due to overlapping indications.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
2.6K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
2.6K
01:19Antiasthma Drugs: Leukotriene Modifiers
372
Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Leukotriene modifiers work through two distinct mechanisms:
372
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
357
Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
357
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
317
Bronchodilators are critical in managing asthma, a chronic respiratory condition characterized by airway constriction due to inflammation and hyper-reactivity. Specifically, bronchodilators ease this constriction by relaxing the bronchial muscles, facilitating easier breathing.
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
317
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
315
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
315
01:20Asthma: Pathogenesis and Management
461
Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
461