Abstract
Current inhaled treatment of moderate to severe persistent asthma is mainly based on inhaled corticosteroids combined with long-acting bronchodiator agents and leukotriene antagonists. Some asthma phenotypes, however, are not well controlled even by this combined antiasthmatic therapy.
In the past two decades, the number of trials evaluating biological treatment has increased dramatically. Three molecules selectively influencing allergic and eosinophil inflammation of the airways are now available in clinical practice.
Biological therapy targeting interleukin 5 or immunoglobulin E does improve asthma control in severe asthmatics with frequent exacerbations. Adding new molecules to treatment requires an experienced clinical judgment concerning the life of the asthmatic patient and dealing with his or her complex illness since many molecules have overlapping effects.
This overview summarizes the current and future options offered by biological therapy in the cascade treatment of asthma.