TY - JOUR
T1 - Biologics for Severe Asthma
T2 - Treatment-Specific Effects Are Important in Choosing a Specific Agent
AU - Krings, James G.
AU - McGregor, Mary Clare
AU - Bacharier, Leonard B.
AU - Castro, Mario
N1 - Funding Information:
Conflicts of interest: L. B. Bacharier has received consultancy and lecture fees from Aerocrine, GlaxoSmithKline (GSK), Genentech/Novartis, Teva, AstraZeneca, Sanofi/Regeneron, and Boehringer Ingelheim; has received lecture fees from and is on the scientific advisory board for Merck; is on the DBV Technologies data safety monitoring board; has received honoraria for Continuing Medical Education (CME) program development from WebMD/Medscape; is on the advisory boards for Vectura and Circassia; and has received research support from Vectura and Sanofi. M. Castro has received university grant funding from the National Institutes of Health, the American Lung Association, Patient-Centered Outcomes Research Institute (PCORI); receives pharmaceutical grant funding from AstraZeneca, Boeringer Ingelheim, Chiesi, GSK, Novartis, and Sanofi-Aventis; has received research support from Amgen, Ception/Cephalon/Teva, Novartis, GSK, Sanofi-Aventis, Vectura, KaloBios, and MedImmune; is a consultant for Aviragen, Neo-stem, Asthmatx/Boston Scientific, IPS/Holaira, Genentech, Mallinckrodt, Nuvaira, Neutronic, Sanofi-Aventis, Teva, Therabron, Theravance, Vectura, 4D Pharma, and VIDA; is a speaker for Astra-Zeneca, GSK, Boeringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; has received honoraria for CME program development from WebMD/Medscape/MedNet; has received consultancy fees and has participated in advisory boards for Genentech; and receives royalties from Elsevier. The rest of the authors declare that they have no relevant conflicts of interest. Conflicts of interest: L. B. Bacharier has received consultancy and lecture fees from Aerocrine, GlaxoSmithKline (GSK), Genentech/Novartis, Teva, AstraZeneca, Sanofi/Regeneron, and Boehringer Ingelheim; has received lecture fees from and is on the scientific advisory board for Merck; is on the DBV Technologies data safety monitoring board; has received honoraria for Continuing Medical Education (CME) program development from WebMD/Medscape; is on the advisory boards for Vectura and Circassia; and has received research support from Vectura and Sanofi. M. Castro has received university grant funding from the National Institutes of Health, the American Lung Association, Patient-Centered Outcomes Research Institute ( PCORI); receives pharmaceutical grant funding from AstraZeneca, Boeringer Ingelheim, Chiesi, GSK, Novartis, and Sanofi-Aventis; has received research support from Amgen, Ception / Cephalon / Teva, Novartis, GSK, Sanofi-Aventis, Vectura, KaloBios, and MedImmune; is a consultant for Aviragen, Neo-stem, Asthmatx/Boston Scientific, IPS/Holaira, Genentech, Mallinckrodt, Nuvaira, Neutronic, Sanofi-Aventis, Teva, Therabron, Theravance, Vectura, 4D Pharma, and VIDA; is a speaker for Astra-Zeneca, GSK, Boeringer Ingelheim, Boston Scientific, Genentech, Regeneron, Sanofi, and Teva; has received honoraria for CME program development from WebMD/Medscape/MedNet; has received consultancy fees and has participated in advisory boards for Genentech; and receives royalties from Elsevier. The rest of the authors declare that they have no relevant conflicts of interest.
Publisher Copyright:
© 2019 American Academy of Allergy, Asthma & Immunology
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Patients with uncontrolled severe persistent asthma have greater morbidity, greater use of health care resources, and more impairment in health-related quality of life when compared with their peers with well-controlled disease. Fortunately, since the introduction of biological therapeutics, patients with severe eosinophilic asthma now have beneficial treatment options that they did not have just a few years ago. In addition to anti-IgE therapy for allergic asthma, 3 new biological therapeutics targeting IL-5 and 1 targeting IL-4 and IL-13 signaling have recently been approved by the Food and Drug Administration for the treatment of severe eosinophilic asthma, and approval of more biological therapeutics is on the horizon. These medications decrease the frequency of asthma exacerbations, improve lung function, reduce corticosteroid usage, and improve health-related quality of life. This article reviews the mechanisms of action, specific indications, benefits, and side effects of each of the approved biological therapies for asthma. Furthermore, this article reviews how a clinician could use specific patient characteristics to decide which biologic treatment may be optimal for a given patient.
AB - Patients with uncontrolled severe persistent asthma have greater morbidity, greater use of health care resources, and more impairment in health-related quality of life when compared with their peers with well-controlled disease. Fortunately, since the introduction of biological therapeutics, patients with severe eosinophilic asthma now have beneficial treatment options that they did not have just a few years ago. In addition to anti-IgE therapy for allergic asthma, 3 new biological therapeutics targeting IL-5 and 1 targeting IL-4 and IL-13 signaling have recently been approved by the Food and Drug Administration for the treatment of severe eosinophilic asthma, and approval of more biological therapeutics is on the horizon. These medications decrease the frequency of asthma exacerbations, improve lung function, reduce corticosteroid usage, and improve health-related quality of life. This article reviews the mechanisms of action, specific indications, benefits, and side effects of each of the approved biological therapies for asthma. Furthermore, this article reviews how a clinician could use specific patient characteristics to decide which biologic treatment may be optimal for a given patient.
KW - Asthma
KW - Asthma treatments
KW - Biologics
KW - Eosinophilic asthma
KW - Monoclonal antibodies
KW - Severe asthma
UR - http://www.scopus.com/inward/record.url?scp=85065059072&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2019.03.008
DO - 10.1016/j.jaip.2019.03.008
M3 - Review article
C2 - 31076056
AN - SCOPUS:85065059072
VL - 7
SP - 1379
EP - 1392
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 5
ER -