Role of biologics in asthma

Mary Clare McGregor, James G. Krings, Parameswaran Nair, Mario Castro

Research output: Contribution to journalArticlepeer-review

284 Scopus citations


Patients with severe uncontrolled asthma have disproportionally high morbidity and healthcare utilization as compared with their peers with well-controlled disease. Although treatment options for these patients were previously limited, with unacceptable side effects, the emergence of biologic therapies for the treatment of asthma has provided promising targeted therapy for these patients. Biologic therapies target specific inflammatory pathways involved in the pathogenesis of asthma, particularly in patients with an endotype driven by type 2 (T2) inflammation. In addition to anti-IgE therapy that has improved outcomes in allergic asthma for more than a decade, three anti–IL-5 biologics and one anti–IL-4R biologic have recently emerged as promising treatments for T2 asthma. These targeted therapies have been shown to reduce asthma exacerbations, improve lung function, reduce oral corticosteroid use, and improve quality of life in appropriately selected patients. In addition to the currently approved biologic agents, several biologics targeting upstream inflammatory mediators are in clinical trials, with possible approval on the horizon. This article reviews the mechanism of action, indications, expected benefits, and side effects of each of the currently approved biologics for severe uncontrolled asthma and discusses promising therapeutic targets for the future.

Original languageEnglish
Pages (from-to)433-445
Number of pages13
JournalAmerican journal of respiratory and critical care medicine
Issue number4
StatePublished - Feb 15 2019


  • Asthma treatments
  • Biologics
  • Eosinophils
  • Monoclonal antibodies
  • Severe asthma


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