Biologics Use in Eosinophilic Lung Disease: Controversies and Consensus

Significant advances in the management of diseases driven by eosinophilic inflammation in the age of biologics provide us with an untapped opportunity to extend these highly effective treatments to other lung diseases that have eosinophils as a central effector cell. Currently, rare diseases such as chronic eosinophilic pneumonia and allergic bronchopulmonary aspergillosis (ABPA) are treated with oral corticosteroids (OCS) and often require long courses of exposure to high doses of OCS. In this era of increased awareness of OCS toxicity and a heightened interest in OCS stewardship, we are obligated to leverage our understanding of the pathophysiology of these diseases to implement strategies that include the use of biologics as therapeutic options. This review focuses on available literature on employing biologics to treat acute and chronic eosinophilic pneumonia, allergic bronchopulmonary aspergillosis, and hypereosinophilic syndrome.