Biologics in severe asthma: a state-of-the-art review

Area of Science:

• Immunology
• Pulmonology
• Pharmacology

Background:

• Severe asthma, uncontrolled by conventional therapy, significantly impacts patients and healthcare systems.
• Advances in understanding asthma heterogeneity and immunopathogenesis have identified key disease pathways.
• These discoveries have enabled the development of targeted biologic therapies.

Purpose of the Study:

• To review the efficacy and safety of currently available biologic therapies for severe asthma.
• To synthesize evidence from randomized controlled trials (RCTs), extension studies, meta-analyses, and real-world data.
• To provide practical perspectives on the application of biologics in personalized asthma management.

Main Methods:

• Systematic review of pivotal RCTs and subsequent studies on approved asthma biologics.
• Analysis of safety and efficacy data from diverse clinical settings.
• Focus on biologics targeting immunoglobulin E, IL-5/IL-5Rα, IL-4Rα, and thymic stromal lymphopoietin.

Main Results:

• Biologic therapies demonstrate significant reductions in exacerbations and hospitalizations.
• These treatments decrease the need for maintenance systemic steroids.
• Patient quality of life is notably improved with biologic interventions.

Conclusions:

• Biologics represent a major advancement in managing severe asthma phenotypes.
• Personalized treatment strategies utilizing biomarkers are crucial for effective asthma management.
• Evidence supports the generalizability and practical application of biologics in real-world settings.