Biological therapies targeting the type 2 inflammatory pathway in severe asthma (Review)

Abstract

Asthma is a variable chronic respiratory disease characterized by airway inflammation and hyperresponsiveness, bronchoconstriction, and mucus hypersecretion. While most patients with asthma achieve good control of the disease, 5-10% experience severe symptoms and recurrent exacerbation despite the maximal offered therapy with inhaled corticosteroids and long acting bronchodilators. In previous years, novel biological therapies have become available, and various asthma phenotypes that are characterized by specific biomarkers have been identified. Currently approved biological agents target inflammatory molecules of the type 2 inflammatory pathway, and are effective at decreasing the frequency of asthma attacks, controlling symptoms and decreasing use of systemic steroids. The present study reviewed the effectiveness and safety profile of the currently approved biological drugs and provided an overview of the assessment of patients with severe asthma who are potentially suitable for biological therapy, in order to help clinicians to select the most appropriate biological agent.

Keywords: biological therapy; biomarkers; monoclonal antibodies; phenotype; severe asthma.

Figure 1

Primary biological drugs used to treat severe persistent asthma according to T2 biomarker profile. T2, type 2; FeNo, fractional exhaled nitric oxide; s.c., subcutaneous; Eos, eosinophils; i.v., intravenous; OCS, oral corticosteroid.