The treatment of severe uncontrolled asthma using biologics

Norio Kodaka; Chihiro Nakano; Takeshi Oshio; Hiroto Matsuse; Norio Kodaka; Chihiro Nakano; Takeshi Oshio; Hiroto Matsuse

doi:10.3934/Allergy.2020001

AIMS Allergy and Immunology

2020, Volume 4, Issue 1: 1-13. doi: 10.3934/Allergy.2020001

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The treatment of severe uncontrolled asthma using biologics

Division of Respiratory Medicine, Department of Internal Medicine, Toho University Ohashi Medical Center, Tokyo, Japan

Received: 12 December 2019 Accepted: 02 March 2020 Published: 06 March 2020

The numbers of deaths due to asthma have decreased because of the development of inhaled corticosteroid (ICS) treatment. However, about 5% of patients with asthma are still difficult to control with ICS treatment. In severe uncontrolled asthma, the balance between type 2 inflammation and non-type 2 inflammation is assumed to be different. Asthma can be said to be a heterogeneous disease; however, several biologics have recently been developed for use in severe uncontrolled asthma. Omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab, targeting type 2 inflammation, have been approved for use worldwide. Severe uncontrolled asthma is heterogeneous, and it is becoming necessary to classify phenotype and endotype for individual patients to determine treatment options. This review will explain treatment options for severe uncontrolled asthma, with a focus on biologics.
- asthma treatment,
- biologics,
- endotype,
- phenotype,
- severe uncontrolled asthma,
- type 2 asthma
Citation: Norio Kodaka, Chihiro Nakano, Takeshi Oshio, Hiroto Matsuse. The treatment of severe uncontrolled asthma using biologics[J]. AIMS Allergy and Immunology, 2020, 4(1): 1-13. doi: 10.3934/Allergy.2020001

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Abstract

The numbers of deaths due to asthma have decreased because of the development of inhaled corticosteroid (ICS) treatment. However, about 5% of patients with asthma are still difficult to control with ICS treatment. In severe uncontrolled asthma, the balance between type 2 inflammation and non-type 2 inflammation is assumed to be different. Asthma can be said to be a heterogeneous disease; however, several biologics have recently been developed for use in severe uncontrolled asthma. Omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab, targeting type 2 inflammation, have been approved for use worldwide. Severe uncontrolled asthma is heterogeneous, and it is becoming necessary to classify phenotype and endotype for individual patients to determine treatment options. This review will explain treatment options for severe uncontrolled asthma, with a focus on biologics.

Conflict of interests

All authors declare no conflicts of interest in this paper.

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