Treatment of severe asthma with biological therapy: a literature review

Karolina Lukošiūtė1, Emilija Globytė1, Viktorija Platonovienė2

1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine, Kaunas, Lithuania

2Klaipėda university hospital, Klaipėda, Lithuania


Introduction. Severe bronchial asthma is defined as asthma in which management of the symptoms is not achieved, or then the control immediately worsens when the previous high doses of the medication are reduced. Due to the symptoms of severe and uncontrolled asthma, patients contact the emergency department. The disease not only disrupts a normal person’s daily routine but also increases the risk of exacerbation of asthma death. Severe asthma often disrupts family and social life, limits career opportunities, and affects emotional and mental health.

Aim: to find out the latest recommendations for biological treatment of severe bronchial asthma. To introduce new biological therapy drugs for the treatment of severe asthma.

Methodology. Review of literature sources was performed. Publications were searched in Medline, PubMed, GoogleScholar databases. Keywords used for data search: biological therapy of severe asthma, severe asthma management. 18 articles were selected and summarized from 2014 to 2021.

Results. Treatment for severe asthma is complex. Omalizumab (anti-IgE) may be used for severe allergic asthma, mepolizumab for severe eosinophilic asthma, reslizumab or benralizumab for anti-IL5 / 5R, and dupilumab for severe asthma type 2 (anti-IL4R). A new generation of biologic therapy studies with tezepelumab and ipetekimab are also currently underway.

Conclusions. Treatment of severe asthma is based on the patient’s complaints, symptoms, clinical signs and instrumentation. Presently, patients with severe asthma are prescribed biologic therapy based on age, disease phenotype, and eosinophil counts.

Keywords: severe asthma, biological therapy, omalizumab, tezepelumab.

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