Asthma is a chronic inflammatory disease of the airway that requires long-term antiinflammatory
therapy. Inhaled
corticosteroids (ICSs) are recommended for first-line treatment of persistent disease, but not all patients achieve
asthma control even when these agents are used in high doses and in combination with other medications, including a long-acting beta(2)-agonist or a
leukotriene modifier. Such patients may require additional
therapy. As information about
asthma pathophysiology and inflammatory phenotypes continues to increase, and additional antiinflammatory options become available, it may be possible to target antiinflammatory
therapy to various aspects of the disease and consequently to improve the treatment of patients with inadequate responses to standard ICS-based
therapy. Several novel antiinflammatory
therapies are in different stages of clinical development. The most clinically advanced of these is
omalizumab, a recombinant humanized
monoclonal antibody that specifically targets
IgE and is indicated for patients with moderate-to-severe
asthma caused by
allergies.
Omalizumab has demonstrated efficacy in patients with moderate-to-severe
asthma and documented evidence of
allergen sensitivity. Other key
therapy options in clinical development either target proinflammatory
cytokines (eg,
interleukin-4 and
tumor necrosis factor-alpha) or inflammatory cells (eg, T-helper type 2 cells and eosinophils). This review provides an overview of the current and future approaches targeting airway
inflammation in patients with
asthma.