Asthma and the Biologics Revolution, Part 2: Failures and the Future Potential

Abstract

To highlight the evidence behind the various biologics that are being developed for asthma along with their specific targets in the inflammatory cascade and the potential role they serve in the management of allergic asthma. The mainstay of asthma management for the majority of asthmatics is inhaled corticosteroids with or without long-acting beta-agonists and/or leukotriene modifiers and/or tiotropium. However, in the small group of individuals with severe asthma uncontrolled with conventional therapy, biologics have emerged as an effective therapeutic option. Asthma is a chronic heterogenous disease affecting both children and adults. In its severe form, asthma is associated with significant morbidity and mortality along with increased healthcare utilization and costs. Several biologics targeting different areas of the asthmatic inflammatory cascade such as IgE and IL-5 have been approved for the management of severe allergic asthma. Recent advances have helped to further uncover the pathophysiology of asthma which have identified other potential targets for therapy in the moderate-to-severe difficult to treat asthmatic population.