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Biologic therapies for severe asthma with persistent type 2 inflammation.
Sahan Chandrasekara1,2, Peter Wark1,2
1Alfred Health, Melbourne.
Australian Prescriber
|May 13, 2024
Summary
Severe asthma, often linked to persistent type 2 inflammation, may not respond to standard treatments. Biologic therapies offer an effective option for managing severe asthma symptoms and reducing exacerbations.
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Asthma is a chronic airway inflammatory disease, frequently involving type 2 inflammation.
- Severe asthma affects 5-10% of patients, characterized by poor symptom control and exacerbations despite optimal inhaled corticosteroid and long-acting beta2 agonist therapy.
- Persistent type 2 inflammation, indicated by elevated blood eosinophils or fractional exhaled nitric oxide, is common in severe asthma.
Purpose of the Study:
- To review the role and efficacy of biologic therapies for severe asthma with persistent type 2 inflammation.
Main Methods:
- Review of current biologic therapies available in Australia for severe asthma.
- Discussion of administration routes, tolerability, and effectiveness.
Main Results:
- Biologic therapies (benralizumab, dupilumab, mepolizumab, omalizumab) are administered subcutaneously and are well-tolerated.
- These therapies significantly improve symptoms, reduce exacerbation rates, and decrease the need for oral corticosteroids in patients with severe asthma and persistent type 2 inflammation.
Conclusions:
- Biologic therapy is indicated for severe asthma patients with persistent type 2 inflammation.
- Inhaled corticosteroid treatment should be continued alongside biologic therapy.
- Biologics represent a crucial advancement in managing difficult-to-treat asthma.
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