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Review
. 2020 Sep 9:13:301-313.
doi: 10.2147/JAA.S258594. eCollection 2020.

Anti-IL5 Therapies for Severe Eosinophilic Asthma: Literature Review and Practical Insights

Francesco Menzella  1 , Patrizia Ruggiero  1 , Giulia Ghidoni  1 , Matteo Fontana  1 , Diego Bagnasco  2 , Francesco Livrieri  1 , Chiara Scelfo  1 , Nicola Facciolongo  1
Affiliations
Review

Anti-IL5 Therapies for Severe Eosinophilic Asthma: Literature Review and Practical Insights

Francesco Menzella et al. J Asthma Allergy. .

Abstract

Severe refractory asthma (SRA) still has a high economic and social impact, including a reduction in quality of life (QoL), productivity, a greater risk of exacerbations and emergency department (ED) visits. Another major issue is the need of oral corticosteroids (OCS), often due to a poor response to standard therapies or the lack of indication for currently available biological drugs. A thorough understanding of the immunological pathways and eosinophilopoietic processes allows a correct application of the new pharmacological strategies and leads to better clinical responses. For these unmet needs, several monoclonal antibody (mAb) drugs have been introduced over the past few years. These are mainly available for allergic and especially eosinophilic uncontrolled refractory asthma. As the number of therapeutic options increases, the choice of biological drugs can be made only after careful considerations of the particular asthma endotype, patients' comorbidities and clinical data. The selection of the correct therapeutic option can therefore be guided after a careful evaluation of the particular endotype and phenotype, from the combined evaluation of inflammatory biomarkers, clinical picture and comorbidities. The careful evaluation of all these parameters can therefore help the physician in the optimal management of these complex patients, for whom it is often possible to achieve exceptional results by managing the available options in the best possible way. The aim of this review is to define the positioning of the biological drugs currently available for type 2 asthma, with a special focus on options for eosinophilic asthma in the context of the most recent knowledge of immunological pathways.

Keywords: IL-5; biomarkers; eosinophilia; oral corticosteroids; pandemic; severe refractory asthma.

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Conflict of interest statement

Francesco Menzella has received research grants from AstraZeneca, Novartis and Sanofi; lecture fees and advisory board fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Mundipharma, Novartis, and Sanofi. The other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
T2 high inflammatory pathways.
Figure 2
Figure 2
Overlapping of biological drugs in the context of inflammatory phenotypes.
See this image and copyright information in PMC

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