Following the round table discussion on the evolving algorithm of biological selection in severe asthma at the REG summit 2019, a new paper has been published, which summarises the reasoning for the use of different add-on medications for severe asthma and selection strategies.
Severe asthma patients, who don’t respond to regular treatments in a satisfactory matter, often require additional treatment. The choice of such interventions should reflect, if possible, the underlying endotype, which may have Type 2 or non-Type 2 immunity characteristics. Recently new treatment options have become available, mostly in the form of monoclonal antibodies (“biologicals”) that target inflammatory pathways.
This paper summarises the key characteristics of different options: non-biologic, anti-IgE, anti-IL5 and anti-IL5 receptor and anti-IL4/IL13 therapies. It presents a common sense, structured approach to disease evaluation, choice of medication and the monitoring/switching between treatments, focusing on simple principles resulting from available evidence and prioritising patient preferences in real life.
https://onlinelibrary.wiley.com/doi/full/10.1111/all.14256
