Abstract
Severe asthma greatly affects patients’ quality of life. Major advances have occurred in the management of severe eosinophilic asthma the past few years due to the new targeted biological therapies. There are three anti-IL-5 mAbs, mepolizumab, reslizumab and benralizumab. Despite the different mechanism of blocking IL-5 the clinical effects are quite similar as randomized controlled trials and real-life studies have shown. Moreover, there are reports of responding to one after failing to respond to another anti-IL-5 therapy. Accordingly, it is challenging to explore the possible differences in the response to anti-IL-5 treatments. This might help us not only understand possible mechanisms that contribute to the resistance to treatment in this particular asthma endotype, but also to phenotype within severe eosinophilic asthma in order to treat our patients more efficiently.
Highlights
One of the first real-life studies assessing the therapeutic effect of benralizumab in severe eosinophilic asthma included 13 patients who were evaluated at baseline and 4 weeks after drug administration
22 patients with severe eosinophilic asthma who had received mepolizumab for ≥24 weeks and presented a suboptimal response defined as either a
Targeted therapies directed against IL-5 and IL-5R for severe eosinophilic asthma have proved effective mainly in reducing asthma exacerbations and the use of daily oral corticosteroids and in improving asthma control and lung function
Summary
A small proportion of them need an escalation of treatment with either oral corticosteroids (OCS) or novel biologics targeting specific molecular pathways, which intertwine with the severity of symptoms and are specific to each patient. This subgroup is termed “severe asthmatics” and includes individuals whose symptoms cannot be controlled under high dose ICS and LABA treatment, or need OCS for several months each year in order to overcome their symptoms.
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