Biologics for Severe Asthma: Treatment-Specific Effects Are Important in Choosing a Specific Agent.

Abstract

Patients with uncontrolled severe persistent asthma have greater morbidity, greater use of health care resources, and more impairment in health-related quality of life when compared with their peers with well-controlled disease. Fortunately, since the introduction of biological therapeutics, patients with severe eosinophilic asthma now have beneficial treatment options that they did not have just a few years ago. In addition to anti-IgE therapy for allergic asthma, 3 new biological therapeutics targeting IL-5 and 1 targeting IL-4 and IL-13 signaling have recently been approved by the Food and Drug Administration for the treatment of severe eosinophilic asthma, and approval of more biological therapeutics is on the horizon. These medications decrease the frequency of asthma exacerbations, improve lung function, reduce corticosteroid usage, and improve health-related quality of life. This article reviews the mechanisms of action, specific indications, benefits, and side effects of each of the approved biological therapies for asthma. Furthermore, this article reviews how a clinician could use specific patient characteristics to decide which biologic treatment may be optimal for a given patient.

• Authors: James G Krings, Mary Clare McGregor, Leonard B Bacharier, Mario Castro
• Journal: The journal of allergy and clinical immunology. In practice (J Allergy Clin Immunol Pract) 2019 May - Jun Vol. 7 Issue 5 Pg. 1379-1392 ISSN: 2213-2201 [Electronic] United States
• PMID: 31076056 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Adrenal Cortex Hormones
• Anti-Asthmatic Agents
• Antibodies, Monoclonal, Humanized
• Biological Products
• Cytokines
• Omalizumab
• reslizumab
• dupilumab
• benralizumab
• mepolizumab

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Anti-Asthmatic Agents (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Asthma (drug therapy, immunology, physiopathology)
• Biological Products (therapeutic use)
• Cytokines (immunology)
• Disease Progression
• Eosinophilia (drug therapy, immunology, physiopathology)
• Humans
• Lymphocytes (immunology)
• Omalizumab (therapeutic use)
• Severity of Illness Index
• Th2 Cells (immunology)